Dassy Levy
Israeli Cardiology and Critical Care Nursing Society, Rambam Health Care Campus, Israel
Title: Relationship between gynecology and cardiology: Updates on hormone replacement therapy and cardiac disease in post menopausal women
Biography
Biography: Dassy Levy
Abstract
The following information based on the latest available evidence can be used to provide guidance to use of Hormone replacement therapy and alternatives. Premenopausal women have a lower risk and incidence of hypertension and cardiovascular disease (CVD) compared to age-matched men and this sex advantage for women gradually disappears after menopause, suggesting that sexual hormones play a cardio protective role in women. However, randomized prospective primary or secondary prevention trials failed to confirm that hormone replacement therapy (HRT) affords cardio protection. This review highlights the factors that may contribute to this divergent outcome and could reveal why young or premenopausal women are protected from CVD and yet postmenopausal women do not benefit from HRT. Observational studies also show that postmenopausal women who receive hormone replacement therapy (HRT) have a lower rate of CVD and cardiac death than those not receiving HRT. However, two randomized prospective primary or secondary prevention trials, the Women’s Health Initiative (WHI) and the Heart and Estrogen/Progestin Replacement Study (HERS I and II)], showed that HRT may actually increase the risk and events of CVD in postmenopausal women. The reasons for this paradoxical characterization of HRT as both beneficial and detrimental remain unclear. Overall, the use of HRT has become one of the most controversial topics related to women’s health, making it all the more urgent to clarify whether estrogens (and/or HRT) prevent or promote CVD, as well as the mechanism(s) involved. HRT has become one of the most controversial topics related to women’s health. Future studies are necessary if we are to understand the divergent published findings regarding HRT and develop new therapeutic strategies to improve the quality of life for women.