Abstract
Studies on the incidence of coronary disease have revealed a well documented, significant primary preventive effect of estrogens, as well as estrogens and progestogens against this important risk of health for postmenopausal women [ 1 Bush T. Barrett-Connor R.E. Cowan L.D. et al. Cardiovascular mortality and non contraceptive estrogen use in women. Results from the lipid Research Clinics Program follow-up study. Circulation. 1989; 75: 1102-1109 Crossref Scopus (1268) Google Scholar , 2 Ginsburg J. Ovarian hormones and vascular function. in: Lippert T.H. Meuck A.O. Ginsburg J. Sex Steroids and the Cardiovascular System. Parthenon, New York1996: 3-20 Google Scholar , 3 Henderson B.E. Ross R.K. Paganini-Hill A. Mack T.M. Estrogen use and cardiovascular disease. Am. J. Obstet. Gynecol. 1986; 154: 1181-1186 Abstract Full Text PDF PubMed Google Scholar , 4 Pekkanen J. Linn S. Heiss G. et al. Ten years mortality from cardiovascular diseases in relation to cholesterol level among men with and without preexisting cardiovascular diseases. New. Engl. J. Med. 1990; 322: 1700-1707 Crossref PubMed Scopus (705) Google Scholar , 5 Psaty B.M. Heckbert S.R. Atkins D. et al. The risk of myocardial infarction associated with the combined use of estrogens and progestins in postmenopausal women. Arch. Intern. Med. 1994; 154: 1333-1339 Crossref PubMed Google Scholar , 6 Rosano G.M.C. Sarrel P.M. Pool-Wilson P.A. et al. Beneficial effect of oestrogen on exercise induced myocardial ischaemia in women with myocardial disease. Lancet. 1993; 342: 133-136 Abstract PubMed Scopus (422) Google Scholar , 7 Stampfer M.J. Colditz G.A. Estrogen replacement therapy and coronary heart disease. A quantitative assessment of the epidemiologic evidence. Prev. Med. 1991; 20: 47-63 Crossref PubMed Scopus (1496) Google Scholar ]. Experimental investigations in castrated and estrogen-treated, cholesterol fed cynomolgus monkeys confirmed these findings [ [8] Wagner J.D. Clarkson T.B. St Clair R.W. et al. Estrogen and progesteron replacement therapy reduces LDL accumulation in the coronary arteries of surgically postmenopausal cynomolgus monkeys. J. Clin. Invest. 1991; 88: 1995-2002 Crossref PubMed Scopus (251) Google Scholar ]. Studies dealing with secondary estrogen–progestogen prevention in patients with existing coronary diseases were less frequently performed [ 2 Ginsburg J. Ovarian hormones and vascular function. in: Lippert T.H. Meuck A.O. Ginsburg J. Sex Steroids and the Cardiovascular System. Parthenon, New York1996: 3-20 Google Scholar , 9 Windler E. Östrogensubstition in der postmenopause zur prävention kardiovaskulärer erkrankungen. in: Beller F.K. Brevier der Menopausenbahandlungn. Pro Verlag, Hofstetten1998: 161-194 Google Scholar ]. This object was investigated in the HERS trial [ [10] Hulley S, Grady D, Bush T, et al. for the Heart and Estrogen/progestin Replacement Study (HERS) Research Group. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. J Am Med Assoc 1998;280:605–13. Google Scholar ].
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