Homocysteine, cardiovascular disease and hormone replacement therapy in post-menopausal women

Deligeoroglou Ε, Tsimaris P, Deliveliotou A

2nd Department Obstetrics and Gynecology, University of Athens, Aretaieio hospital, Athens, Greece

Correspondence: Deligeoroglou E, 48 Marathonos St, GR-15235, Brilissia, Athens, Greece. E-mail: edeligeo@aretaieio.uoa.gr


Homocysteine (Hcy) is a sulfated amino acid deriving from methionine. Hcy’s metabolism, as well as the association of Hcy with cardiovascular disease (CVD) are extensively illustrated in this review article. The precise mechanism by which Hcy is involved in the pathogenesis and establishment of CVD, which is the leading cause of morbidity and mortality in postmenopausal women, is not yet completely understood. We reviewed the effect of all different kind of hormone replacement therapies on homocysteine blood levels and we concluded that the majority of them lead to a remarkable reduction. This does not apply to the HRT effect on other independent predictive factors of cardiovascular disease, such as CRP, IL-6 and Lp(a). Hormone replacement therapy should only be recommended safely for CVD prevention in postmenopausal women, if a positive correlation of HRT with all predictive factors of CVD is established. More research is needed in order to clarify the exact role of each independent predictive factor, as well as the hormone replacement therapy effect on cardiovascular system of postmenopausal women.

Keywords: homocysteine, cardiovascular disease, hormone replacement therapy, menopause

p. 181-189