Effects of hormone replacement therapy and estrogen receptor modulators on markers of inflammation and coagulation.

The lipid-lowering effects of hormone replacement therapy (HRT) can only partly explain the possible decrease in cardiovascular risk noted in observational studies with hormone use in postmenopausal women. Other possible mechanisms have been explored, including the role of inflammation and coagulation factors. There is mounting evidence that inflammation plays a critical role in the pathogenesis of atherosclerosis, and it has been demonstrated that higher levels of circulating proinflammatory factors are predictive of cardiovascular events. Thus, the effects of hormones and other agents on these factors are of considerable interest. In this article, the effects of various types of HRT and estrogen receptor modulators on inflammation and coagulation markers are reviewed, and their potential impact on clinical outcomes is considered.