Abstract
There is an ongoing discussion on the risk-benefit-ratio of hormonal replacement therapy (HRT). Potential risks of oestrogen replacement include the progression of malignant tumours. However postmenopausal morbidity can be significantly reduced by HRT. There is increasing evidence that oestrogens exercise protective effects on the cardiovascular system. HRT can reduce the development of atherosclerotic lesions and the rate of fatal myocardial infarction due to atherosclerosis. Oestrogens have direct and indirect effects on vascular physiology. Indirect effects derive from modulation of lipid metabolism. In addition, oestrogens may exert direct effects on vascular cells e.g. endothelial and smooth muscle cells by receptor-mediated mechanisms (so called genomic effects) and receptor-independent actions (=non-genomic effects). Especially these non-genomic oestrogen effects have been attracting much attention during recent years.
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