So women are at risk for cardiovascular disease. Heart attack is the number one killer of women. So menopausal women are at higher risk for cardiovascular disease, but it's also important that menopausal women that are put on hormone replacement therapy after the age of 65 are at higher risk for cardiovascular disease and stroke. And the reason for that is because all of us, as we age, are building up plaque in our vascular tree. So all just by virtue of living. So we all have plaque. If an older woman that has developed plaque, whether she's a regular woman, not at higher risk for cardiovascular disease, or whether she's a woman with high cholesterol and hypertension, and risk for cardiovascular disease. If you put that older woman on estrogen, she is at higher risk for a thromboembolic event or stroke. So we are very careful about starting hormone replacement therapy earlier rather than later. Earlier when the woman is symptomatic and in the throes of symptoms, not later after she's already experienced all the symptoms, I have a lot of those patients will say, well, I want to take it for my hair and nails, or my friend is taking it and you know, for her vaginal dryness. You're at higher risk if you take it later, over the age of 65.
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