MidLife
PEPI - New possibilities for hormone replacement therapy
Women can greatly reduce their chance of developing heart disease by following certain behaviors--eating low-saturated fat, low-cholesterol foods; not smoking; being physically active; and keeping a healthy weight. But, if estrogen helps protect women against heart disease, then it might offer another valuable preventive measure for many women past menopause.
Through the years, evidence has accumulated suggesting that estrogens
act on some of the factors that define a woman's risk of heart disease. For instance, estrogen seems to affect the levels in the blood of two important lipoproteins--high-density lipoprotein (HDL) and low-density lipoprotein (LDL). High-density lipoprotein helps remove cholesterol from the blood and is called the "good" cholesterol. Low-density lipoprotein carries most of the cholesterol and fat through blood vessels, where it can build up. LDL is called the "bad" cholesterol. Both HDL and LDL are important risk factors for heart disease.
For women, a low level of HDL appears to be the better predictor of heart disease risk--for men; a high LDL appears to be the better predictor. Estrogen seems to increase HDL and decrease LDL. But it was thought that in addition to its benefits, estrogen use alone also posed risks--such as increasing both blood pressure and the chance of cancer of the endometrium, the lining of the uterus.
The increased risk of endometrial cancer associated with estrogen-only therapy seems to be eliminated when estrogen is given with progestin. However, it was not known whether combined therapy might negate estrogen's beneficial effects on heart disease risk factors and bone loss.
Source: The National Heart, Lung and Blood Institute
