Extraskeletal effects of estrogen and the prevention of atherosclerosis.

A cumulative effect has been calculated by Henderson et al. concerning the estimated changes in mortality with estrogen therapy. Even assuming a twofold increase in the risk of breast cancer, the benefits derived from reduction of osteoporotic fractures and the decreased risk of heart disease, demonstrate a 41% decrease in mortality in women who receive estrogen therapy. Since cardiovascular disease is the major cause of morbidity and mortality in postmenopausal women, and since the beneficial effects of estrogen outweigh the documented and perceived risk of estrogen use, estrogen ought to be considered as prophylactic therapy, particularly in women at risk of heart disease.