Oestrogen Replacement Therapy and Cardiovascular Disease

Loss of ovarian activity appears to result in an increased risk of cardiovascular disease. Men have higher mortality rates from cardiovascular disease at all ages, but the male to female ratio varies substantially throughout life [1]. The peak ratio occurs in conjunction with the female menopause and declines thereafer. In fact, in one large prospective study in which incident cardiovascular events were closely monitored, male and female rates of cardiovascular disease were indistinguishable by age 70 [2]. In the same study, at any given age women who were postmenopausal had substantially higher rates of cardiovascular disease than premenopausal women [3]. Furthermore, bilateral oophorectomy at a young age has long been known to result in premature development of atherosclerosis and an increased occurrence of its clinical outcomes [4,5].