CLINICAL REVIEW 27 Effects of Hormonal Replacement on Lipids and Lipoproteins in Postmenopausal Women

HEART disease is the leading cause of death in women and accounts for 500,000 deaths annually, compared to only 250,000 for cancer. Of the $60 billion spent annually in the United States for the treatment of heart disease, 58% of this expense is attributable to disease in women. Unfortunately, however, virtually all appropriations of funding for research in the prevention and treatment of heart disease are for men. Several lines of evidence suggest that both the morbidity and mortality of heart disease in postmenopausal women are increased compared to those in men. Heart disease after menopause is a more devastating disease. The focus of this review, therefore, is to explore the hypothesis that lipids may be implicated in this cardiovascular (CV) risk and to analyze the effects of hormonal replacement therapy (HRT) on lipids and lipoproteins. Cardiovascular Disease: The Influence of Cholesterol The incidence of cardiovascular disease (CVD) rises substantially with aging after the natural menopause, but only equates the incidence in men in the seventh decade.