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(Hypertension. 2004;44:390.)
© 2004 American Heart Association, Inc.

Editorial Commentaries

Targeting of the Renin-Angiotensin System as an Adjunct to Estrogen Replacement Therapy

From Louisiana State University Health Sciences Center, School of Medicine in New Orleans, Department of Physiology.

Correspondence to Lisa M. Harrison-Bernard, Associate Professor, State University Health Sciences Center, School of Medicine in New Orleans, Department of Physiology, Box P7-3, Room 7213, 1901 Perdido Street, New Orleans, LA 70112-1393. E-mail lharris@lsuhsc.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Cardiovascular diseases are the leading cause of death in women and claim the lives of more than half a million women every year. The incidence of cardiovascular disease is 4-fold higher in postmenopausal women than in women of the same age who are premenopausal.¹ Hypertension is a major risk factor for cardiovascular disease. It has been shown that after adjustment for age and body mass index, postmenopausal women are more than twice as likely to be hypertensive as premenopausal women.² Evidence that hypertensive postmenopausal women are more salt-sensitive than normotensive postmenopausal women³ suggests that decreases in ovarian hormone levels and increased sensitivity to dietary sodium may be important factors in the genesis of postmenopausal hypertension. Thus, after menopause, hypertension may contribute to the increase in cardiovascular risk of postmenopausal women. The mechanisms responsible for the increase in blood pressure after menopause are still under investigation.^4,5

In the United States alone, 38% of postmenopausal,⁶ or 10 million, women use some form of hormone replacement therapy. There is quite a bit of controversy over the cardiovascular health benefits of estrogen replacement therapy, especially in light of the cessation of the estrogen-alone component of the National Heart, Lung and Blood Institute–funded Women’s Health Initiative (WHI) hormone trial earlier this year. Results of the nearly 7-year follow-up of 11 000 healthy postmenopausal women using conjugated equine estrogen or placebo who had a hysterectomy showed an increased risk of stroke and no reduction in the risk of coronary heart disease.⁷ Additionally, the estrogen plus progestin . . . [Full Text of this Article]

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