WHAT IS MEANT BY ARTERIAL DISEASE?

Artery is the vessel that carries purified, oxygenated blood from the heart to each and every cell of the body. Due to any disruption of this blood supply, the affected organ virtually dies. Diseases of the arteries, likely to compromise arterial circulation, are grouped under the umbrella of arterial disease.

WHAT ARTERIES ARE MOST AFFECTED?

Organs where blood supply is most essential for survival, viz heart, brain etc are most commonly affected.

BUT WHY ARE WE TALKING OF ARTERIAL DISEASE IN RELATION TO MENOPAUSE?

HRT is given to menopausal women because it helps prevent osteoporosis and has a protective effect on the cardiovascular sytem, ie mainly protects from heart disease and hypertension.

WHY DO WE BELIEVE THAT FEMALE SEX HORMONES INFLUENCE ARTERIAL DISEASE RISK?

Epidemiological studies have reported that around 40-50 years of age, more men die from arterial disease (particularly heart attack) than women. This excess ratio rapidly diminishes thereafter and by 65-70 years of age the death rates between both sexes are similar. There are two explanations for this.
Firstly, that the males, genetically, are at a very high risk for arterial disease. The majority, ie with risk factors , die by age 50 years leaving only those at low risk.

The second explanation is that premenopausal women are protected against arterial disease. Following menopause, this protection is lost and death rates in postmenopausal women rise and eventually equal those in the male population. In several studies, postmenopausal women were found to be at a higher risk as compared to their premenopausal counterparts. Premature menopause increases arterial disease risk, almost two-fold. Loss of ovarian function, thus, appears to increase arterial disease risk.

WHY IS ARTERIAL DISEASE SO IMPORTANT IN WOMEN?

Because it is the commonest cause of death in women aged over 50 years and kills approximately one woman in four. Because it is so common, any major effect of HRT in reducing arterial disease risk is likely to be of considerable benefit.