Post-menopausal hormone therapy and cardiovascular events: a new paradigm based on pharmacogenetics?
The risk of coronary heart disease (CHD) events increases in women after menopause and it was thought that hormone therapy (HT) would decrease this risk. However, numerous large randomized clinical trials have not demonstrated decreased risk in secondary prevention and some have actually shown increased risk of cardiovascular events with HT in primary prevention. Platelets are involved in CHD events and platelet glycoprotein single-nucleotide polymorphisms may help to identify risk and treatment efficacy. It may become a plausible strategy in the future for clinicians to identify, by genotyping, high-risk patients who would benefit from HT to reduce CHD risk as well as to identify patients with neutral risk for whom HT could be harmful.
Cooke
Glen E
GE
The Ohio State University, 235 Davis Heart and Lung Research Institute, 473 W. 12th Ave, Columbus, OH 43210-1252, USA. glen.cooke@osumc.edu