Fourfold primacy of androidally obese, periclimacteric and mildly hirsute women was found in microvascular angina pectoris. It indicates a hyperandrogenic condition and possible deficit of estrogens in its ethiopathogenesis and possible beneficial effect of estrogens replacement in climacterium and whole menopause. HRT with estrogens or combination of estrogens and gestagens in the period of climacterium and menopause, despite of high costs, did not prove to be beneficial in the prevention of cardiovascular diseases, because it does not slow down but speeds up the process of atherothrombogenesis, outbreak of thromboembolitic complications and acute coronary and cerebrovascular episodes, as well as risks of cancer of breasts, endometrium and thyroid gland. In prevention and treatment of microvascular angina pectoris and developed ischemic heart disease are mostly applied non pharmacological interventions to affectable risk factors. If target values of BP, LDL-cholesterol, glycaemia, and weight are not reached, the treatment of dyslipoproteinaemia with statins or fibrates is indicated. In hypertension low doses of thiazide diuretics, beta 1- blockers, ACE-inhibitors and calcium channel antagonists of the 3rd generation are considered. Early complex treatment of DM 2 involving the use of insulin sensibilisators is important.