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Cardiovascular Research 2006 70(1):22-30; doi:10.1016/j.cardiores.2005.12.004
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Copyright © 2006, European Society of Cardiology

Controversies regarding hormone therapy: Insights from inflammation and hemostasis

Kwang Kon Koha,* and Byung-Koo Yoonb

aVascular Medicine and Atherosclerosis Unit, Division of Cardiology, Gil Medical Center, Gachon Medical School, 1198 Kuwol-Dong, Namdong-Gu, Incheon, Korea 405-760
bObstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University,School of Medicine, Seoul, Korea

* Corresponding author. Tel.: +82 32 460 3683; fax: +82 32 460 3117. Email address: kwangk{at}gilhospital.com

Many observational studies and experimental and animal studies have demonstrated that estrogen therapy (ET) or hormone therapy (HT) significantly reduces the risk of coronary heart disease. Nonetheless, recent randomized controlled trials and the Nurses' Health Study in secondary prevention demonstrate trends toward an increased risk of cardiovascular events rather than a reduction of risk from HT. HT has both anti-inflammatory and pro-inflammatory effects, and it activates coagulation and improves fibrinolysis. These effects depend on the route of administration, doses of estrogen, age of women, and the presence of coronary artery disease or the coexistence of other risk factors for hypercoagulability. In this review, we discuss effects of HT on markers of inflammation, hemostasis, and fibrinolysis that may link endothelial dysfunction in cardiovascular diseases. We also briefly discuss effects of lower doses of HT and tibolone in postmenopausal women.

KEYWORDS Hormone therapy; Lower doses; Tibolone; Inflammation; Hemostasis

Time for primary review 29 days


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