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[Menopause and cardiovascular risk factors. Influence of treatments].

Along with menopause goes an increase of cardiovascular heart disease risk, and at the same time a change in certain risk factors. Those risk factor changes are analysed. The most obvious change is cholesterol increase, mostly on its LDL fraction linked to a decrease of its regular epuration. Today, the influence of replacement therapy on cardiovascular heart disease risk is not well known, and this is due mostly to the fact that there are no randomized studies. Thus exists a selection of women with low risk levels, either at the beginning or during follow-up. As a consequence results are necessarily optimized. It is possible to extrapolate the risk factor evolution under treatment only if its mechanism is known. Thus, when estradiol is given not the oral route, lipidic balance is brought back to its premenopausal state, without any noticeable influence on other known risk factors. It is thus reasonable to see there a favorable influence. When estradiol or any other similar molecule is given the oral route, one can notice, depending on the dose and the molecule, similar changes, along however with other variations which actual consequences remain unknown, like the increase of certain coagulation factors, of angiotensinogen, of triglycerides on HDL cholesterol. In particular, one does not know if those last pharmacological changes do not have a negative effect on predisposed patients.