Diabetologists in Vidyaranyapura, Bangalore •
Postmenopausal changes
The lower incidence of coronary heart disease in women under 60 has been thought to be
related to the protective effect of oestrogens. This has led to trials of hormone replacement
therapy (HRT) in postmenopausal women.23 The results of these trials were surprising to
many of the investigators. HRT provided no protection to postmenopausal women. In some
groups there was an increased risk of myocardial infarction, especially in the first year. There
was a definite increase in the risk of stroke and venous thromboembolism, and there was a
probable increased risk of breast cancer. At the moment HRT has no role in the prevention of
cardiovascular disease.