ABSTRACT
There is now evidence that oestrogens will
improve endothelial function and hence
vascular tone,10 however, the effect of
progestogens on CVD risk is controversial.
Progestins are prescribed together with
oestrogens to protect the endometrium, and
some of the most commonly prescribed
progestins have been shown to oppose
partially the beneficial effect of oestrogens on
CVD risk markers.11 However, several
categories of progestins may be prescribed,
and there are striking differences according to
However, evidence-based medicine does
not rely on surrogate markers of risk and the
relationship between hormone replacement
therapy (HRT) and heart disease can be
demonstrated only by randomized controlled
trials (RCT) with cardiovascular events as
main outcomes.
