Hormonalna terapia okresu menopauzy – spojrzenie okiem hipertensjologa

The results of experimental studies and clinical observations from the last two decades indicate the beneficialimpact of oestrogens on the cardiovascular system. However, later published large randomized clinical trials(WHI, HERS) did not confirm the benefits of hormonal substitution in primary as well as secondary preventionof cardiovascular diseases in women. Thus it was concluded that the studies should be designed and interpretedin a different way. The reasons for these discrepancies are probably the different effects of oestrogens onthe healthy and atherosclerotically changed coronary arteries. We cannot expect that the oestrogens, even inlong-term treatment, would reverse the process in an already changed artery wall, which was progressing foryears. The time of the start of hormone replacement after the occurrence of menopause may also be significant.The WHI clinical trial, which was by the opponents considered as proof of the lack of benefits of this therapyin primary prevention, concerned a population of women who had been after the menopause for many years.