The status of hormonal therapy for the primary and secondary prevention of atherosclerotic coronary heart disease

Abstract

E XTENSIVE EVIDENCE is available implicating hormonal derangements in the multifaetorial etiology and pathogenesis of atherosclerotie disease. It has also been repeatedly demonstrated that several hormones--including growth hormone, andrenocorticotrophic hormone, corticoids, thyroid preparations, estrogens and androsterone~tend to lower serum cholesterol-lipid]ipoprotein concentrations. 15 Since hyperlipidemia has been unequivocally shown to increase the risk of premature clinical atherosclerotic coronary heart disease 2,5a~ the concept has inevitably developed that therapy with cholesterol-lowering hormones might be effective against this disease. The purposes of this paper are to review briefly the rationale for the use of specific hormones for the primary and secondary prevention of clinical atherosclerotie disease, and to summarize the present status of investigation in this field. Although multiple hormonal influences have been demonstrated, research on therapeutic application has been almost exclusively confined to thyroid hormones and estrogens--plus recent studies on androsterone, and on the combined use of thyroid preparations and corticosteroids. This paper, therefore, is limited to a discussion of these agents.*