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Hypertension. 2004;44:789-795
Published online before print October 11, 2004, doi: 10.1161/01.HYP.0000145988.95551.28
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(Hypertension. 2004;44:789.)
© 2004 American Heart Association, Inc.

Brief Review

Hormone Replacement Therapy and Cardiovascular Disease

What Went Wrong and Where Do We Go From Here?

Raghvendra K. Dubey; Bruno Imthurn; Lefteris C. Zacharia; Edwin K. Jackson

From the Center for Clinical Pharmacology (R.K.D., B.I., C.Z.L., E.K.J.), Departments of Medicine (R.K.D., C.Z.L., E.K.J.) and Pharmacology (E.K.J.), University of Pittsburgh Medical Center, Pittsburgh, Pa; University Hospital Zurich (R.K.D., B.I.), Department of Obstetrics and Gynecology, Clinic for Endocrinology, Zurich, Switzerland.

Correspondence to Dr Raghvendra K. Dubey, Clinic for Endocrinology (D217, NORD-1), Department of Obstetrics and Gynecology, University Hospital Zurich, Frauenklinikstrasse 10, CH-8051, Zurich, Switzerland. E-mail Raghvendra.dubey{at}usz.ch

Observational studies in humans and experimental studies in animals and isolated cells supported the widely held belief that hormone replacement therapy protects the cardiovascular system from disease. To nearly everyone’s astonishment, the Women’s Health Initiative Study and the Heart and Estrogen/Progestin Replacement Study overturned the conclusion that hormone replacement therapy protects the cardiovascular system and, in fact, supported the opposite view that such therapy may actually increase the risk of cardiovascular disease. This review addresses 2 questions: what went wrong and where do we go from here?


Key Words: estrogen • hormones • cardiovascular diseases




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