PEPI in Perspective

Abstract
Estrogen is good for a woman's heart. While generally accepted when the estrogen is produced naturally, this theory has been a matter of great controversy when the estrogen is administered "artificially" in hormone replacement therapy (HRT) for women during and after menopause. After a half century of conflicting data, we can affirm with growing confidence that, at the very least, estrogen reduces key cardiovascular risk factors in women at a time when they become especially vulnerable to heart disease, namely, after 50 years of age. See also p 199. In this issue ofThe Journal, the Postmenopausal Estrogen/Progestin Interventions (PEPI) investigators report on one aspect of the many findings that we can expect to learn over the next few years from their important National Institutes of Health (NIH)-supported multicenter efforts.1Their report focuses on the effect of HRT, given in four different formulations, compared with short-term use of placebo

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