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. Author manuscript; available in PMC: 2023 Jan 1.
Published in final edited form as: Cancer J. 2022 May-Jun;28(3):208–223. doi: 10.1097/PPO.0000000000000591

Figure 4.

Figure 4

Results of the Estrogen in the Prevention of Atherosclerosis Trial (EPAT) (5) and the Women’s Estrogen-Progestin Lipid-Lowering Hormone Atherosclerosis Regression Trial (WELL-HART) (6) in relation to the pathogenic sequence of vascular aging substantiating the “healthy endothelium hypothesis.” Initiation of hormone replacement therapy (HRT) early and continued while endothelium is intact, maintains vascular health, and reduces vascular aging and progression of atherosclerosis (5). On the other hand, HRT initiated during late-stage atherosclerosis has no effect on established vascular disease (6). MMP = matrix metalloproteinase