[Hormonal treatment for menopause and arterial risk].
Is hormonal atmosphere before menopause the cause of the lower risk of coronary heart disease in women? Big clinical trials do not validate this hypothesis, however simple and attractive: in 5 primary or secondary prevention trials, estrogens alone or in association with progestatives to near 32000 women after menopause, do not leave hope for a significant reduction of coronary risk, and show in contrast an 30% increase of stroke risk. These results highlight the crucial importance of clinical trials to validate therapeutic models. The remaining hypotheses on the nature of hormonal treatments and the administration route must follow the same validation process. The prescription of hormonal treatment for menopause illustrates the importance of informed decision including individualised estimate of the risk to benefit ratio.
Gueyffier
François
F
Centre d'investigation clinique et service de pharmacologie clinique, EA3736, hôpital Louis-Pradel, Hospices civils de Lyon, 69677 Bron Cedex.
Cornu
Catherine
C
D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D003657:Decision Making; D005260:Female; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000517:prevention & control