Although so many women are at risk, especially women after menopause, few recognize the risk factors and take steps to reduce them. If left untreated, coronary heart disease leads to heart attack and heart failure. Upon reaching menopause, a woman's risk for heart disease equals if not surpasses a man's risk. Cholesterol levels that were kept in check by estrogen production may surge upward. Hormone replacement therapy may reduce the sudden increased risk, but may at the same time promote an increased risk for breast and ovarian cancer.
Research is still ongoing on the relationship between hormone replacement and heart disease risk.
What we do know is that the replacement of hormones helps hot flashes and other symptoms of menopause and that estrogen prevents osteoporosis. Whether it is helpful in the prevention of heart disease is the focus of our ongoing research. It appeared there was actually a higher chance of heart attack in the first year of hormone replacement, offset by a lower risk of heart attack after two or more years of treatment. Now the National Institute of Health's Women s Health Initiative, a study examining whether hormone replacement reduces heart attacks in women who do not yet have heart disease. The Women's Health Initiative has enrolled 160,000 women at 40 sites across the country.