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Secondary Prevention of Coronary Heart Disease in Women: A Call to Action

Andrew P. Miller, MD; and Suzanne Oparil, MD
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From The University of Alabama at Birmingham; Birmingham, AL 35294-0007

Requests for Single Reprints: Suzanne Oparil, MD, The University of Alabama at Birmingham, 1034 Zeigler Research Building, 703 19th Street South, Birmingham, AL 35294-0007; e-mail, soparil@uab.edu.

Current Author Addresses: Drs. Miller and Oparil: The University of Alabama at Birmingham, 1034 Zeigler Research Building, 703 19th Street South, Birmingham, AL 35294-0007.

Ann Intern Med. 2003;138(2):150-151. doi:10.7326/0003-4819-138-2-200301210-00017
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On the basis of extensive mechanistic evidence from in vitro and animal studies and clinical evidence from observational studies, it was predicted that postmenopausal hormone replacement therapy would protect women from coronary heart disease (CHD) events. However, the results of randomized, controlled trials available to date have not supported this prediction (13). In fact, the studies have shown evidence of harm—increased CHD events in the first year of treatment and increased stroke and venous thromboembolic events. Although these trials have acknowledged limitations, including use of only a single hormone preparation and participation of older women after many hormone-free years (a practice not usually followed in clinical care), the consistency of these results clearly does not support the use of postmenopausal hormones for prevention or treatment of CHD in women (4).

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