Cardiovascular effects of raloxifene: the arterial and venous systems.
BACKGROUND
Cardiovascular disease caused by atherosclerosis is the largest single killer of women. Prior observational data had suggested that hormone therapy may have cardioprotective effects.


METHODS
Data from clinical trials and basic science studies were evaluated to assess the cardiovascular effects of hormone therapy and selective estrogen replacement modulators.


RESULTS
Hormone therapy does not appear to lower the risk of cardiovascular events in older postmenopausal women. Selective estrogen receptor modulators (SERMS) have been approved for human use; tamoxifen is used for treatment and prevention of breast cancer and raloxifene is used for the treatment and prevention of osteoporosis. Raloxifene is the only SERM being specifically studied for its effects on coronary heart disease events in a prospective, randomized, controlled trial.


CONCLUSIONS
Although raloxifene does increase venous thromboembolic events, there is suggestive data that it may have favorable effects on the arterial systems in women. Only compelling positive data from the Raloxifene Use for The Heart (RUTH) trial will lead to greater use of SERMS to potentially lower the risk of atherosclerotic vascular disease.
Blumenthal
Roger S
RS
The John Hopkins Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Baltimore, Md 21287, USA. rblument@jhmi.edu
Baranowski
Bryan
B
Dowsett
Sherie A
SA
D001158:Arteries; D001161:Arteriosclerosis / Q000097:blood / Q000517:prevention & control*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008055:Lipids / Q000097:blood; D017698:Postmenopause; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use*; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use*; D013923:Thromboembolism / Q000097:blood / Q000517:prevention & control*; D014680:Veins
D015415:Biomarkers; D018836:Inflammation Mediators; D008055:Lipids; D020845:Selective Estrogen Receptor Modulators; D020849:Raloxifene Hydrochloride