Biomaterial Database

The menopause and HRT. Hormone replacement therapy, cardiovascular and cerebrovascular disease. 2003

Helena J Teede

Monash University Department of Medicine, Vascular Medicine and Sciences Unit, Dandenong Hospital, David Street, Dandenong, Victoria 3175, Australia. h.teede@southernhealth.org.au

Historically, research into vascular effects of hormone replacement therapy (HRT) poignantly highlights the difficulties in extrapolating from medical research into clinical practice. Original observational trials encouraged great enthusiasm that HRT was protective against coronary heart disease (CHD) in post-menopausal women. This was supported by a plethora of beneficial mechanistic effects of HRT on the vascular system. In contrast, recent controlled trials have shown that a specific combined oral HRT actually causes a small increased risk of cardiovascular and cerebrovascular events, compared to placebo. The absolute risks were small, yet were accompanied by increased venous thrombosis and breast cancer. Although many controversies still remain regarding the vascular effects of specific types of HRT, currently, in my opinion, all HRT should be considered as causing a small increased risk of vascular events, until proven otherwise. However, the apparent lack of HRT effectiveness in the prevention of vascular disease should not deter enthusiasm for the use of established preventive therapies, especially lifestyle measures.

UI	MeSH Term	Description	Entries
D008593	Menopause	The last menstrual period. Permanent cessation of menses (MENSTRUATION) is usually defined after 6 to 12 months of AMENORRHEA in a woman over 45 years of age. In the United States, menopause generally occurs in women between 48 and 55 years of age.	Change of Life, Female
D001808	Blood Vessels	Any of the tubular vessels conveying the blood (arteries, arterioles, capillaries, venules, and veins).	Blood Vessel,Vessel, Blood,Vessels, Blood
D002318	Cardiovascular Diseases	Pathological conditions involving the CARDIOVASCULAR SYSTEM including the HEART; the BLOOD VESSELS; or the PERICARDIUM.	Adverse Cardiac Event,Cardiac Events,Major Adverse Cardiac Events,Adverse Cardiac Events,Cardiac Event,Cardiac Event, Adverse,Cardiac Events, Adverse,Cardiovascular Disease,Disease, Cardiovascular,Event, Cardiac
D004967	Estrogens	Compounds that interact with ESTROGEN RECEPTORS in target tissues to bring about the effects similar to those of ESTRADIOL. Estrogens stimulate the female reproductive organs, and the development of secondary female SEX CHARACTERISTICS. Estrogenic chemicals include natural, synthetic, steroidal, or non-steroidal compounds.	Estrogen,Estrogen Effect,Estrogen Effects,Estrogen Receptor Agonists,Estrogenic Agents,Estrogenic Compounds,Estrogenic Effect,Estrogenic Effects,Agents, Estrogenic,Agonists, Estrogen Receptor,Compounds, Estrogenic,Effects, Estrogen,Effects, Estrogenic,Receptor Agonists, Estrogen
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013927	Thrombosis	Formation and development of a thrombus or blood clot in BLOOD VESSELS.	Atherothrombosis,Thrombus,Blood Clot,Blood Clots,Thromboses
D015914	Estrogen Replacement Therapy	The use of hormonal agents with estrogen-like activity in postmenopausal or other estrogen-deficient women to alleviate effects of hormone deficiency, such as vasomotor symptoms, DYSPAREUNIA, and progressive development of OSTEOPOROSIS. This may also include the use of progestational agents in combination therapy.	Hormone Replacement Therapy, Post-Menopausal,Postmenopausal Hormone Replacement Therapy,Replacement Therapy, Estrogen,Estrogen Progestin Combination Therapy,Estrogen Progestin Replacement Therapy,Estrogen Replacement,Replacement, Estrogen,Therapy, Estrogen Replacement,Estrogen Replacement Therapies,Estrogen Replacements,Hormone Replacement Therapy, Post Menopausal,Replacement Therapies, Estrogen,Replacements, Estrogen,Therapies, Estrogen Replacement
D016032	Randomized Controlled Trials as Topic	Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.	Clinical Trials, Randomized,Controlled Clinical Trials, Randomized,Trials, Randomized Clinical
D020845	Selective Estrogen Receptor Modulators	A structurally diverse group of compounds distinguished from ESTROGENS by their ability to bind and activate ESTROGEN RECEPTORS but act as either an agonist or antagonist depending on the tissue type and hormonal milieu. They are classified as either first generation because they demonstrate estrogen agonist properties in the ENDOMETRIUM or second generation based on their patterns of tissue specificity. (Horm Res 1997;48:155-63)	Estrogen Receptor Modulators, Selective,SERMs,Estrogen Receptor Modulator, Selective,SERM,Selective Estrogen Receptor Modulator