The menopause and lipid metabolism: strategies for cardiovascular disease prevention.

The menopause and its biology are as yet still incompletely understood. Very little is known about biological and molecular changes in cardiovascular target tissues and organs after menopause. Experimental and clinical evidence indicate that prevention of cardiovascular disease by estrogens is aimed both at the correction of risk factors and at the direct control of vessel structure and function. The effects of progestogens on these processes are still debated. Few other medical interventions have as great a potential for affecting morbidity and mortality as does hormone replacement therapy in postmenopausal women. Hormone replacement therapy has produced effects on health risk, some are reduced, some are raised, while some remain uncertain, suggesting that further testing through specific clinical trials are required before confident recommendations can be made about the full range of benefits and risks. Lipid lowering therapy may be an acceptable alternative for postmenopausal women at risk for cardiovascular disease.