We found high quality evidence that hormone therapy in both primary and secondary prevention conferred no protective effects for all-cause mortality , cardiovascular death , non-fatal myocardial infa rct ion , angina , or revascularisation .
There was no strong evidence of effect on risk of stroke in this group .
Our review findings provide strong evidence that treatment with hormone therapy in post-menopausal women overall , for either primary or secondary prevention of cardiovascular disease events has little if any benefit and causes an increase in the risk of stroke and venous thromboembolic events
BACKGROUND Evidence from systematic review s of observational studies suggests that hormone therapy may have beneficial effects in reducing the incidence of cardiovascular disease events in post-menopausal women , however the results of r and omised controlled trials ( RCTs ) have had mixed results .
This is an up date d version of a Cochrane review published in 2013 .
OBJECTIVES To assess the effects of hormone therapy for the prevention of cardiovascular disease in post-menopausal women , and whether there are differential effects between use in primary or secondary prevention .
Secondary aims were to undertake exploratory analyses to ( i ) assess the impact of time since menopause that treatment was commenced ( ≥ 10 years versus < 10 years ) , and where these data were not available , use age of trial participants at baseline as a proxy ( ≥ 60 years of age versus < 60 years of age ) ; and ( ii ) assess the effects of length of time on treatment .
Conjugated equine estrogens and coronary heart disease: the Women's Health Initiative.
BACKGROUND In recent r and omized trials , conjugated equine estrogens ( CEE ) with continuous medroxyprogesterone acetate provided no protection against coronary heart disease in postmenopausal women and may have increased cardiac risk . These trials did not address the role of unopposed estrogen for coronary protection . METHODS A total of 10 739 women aged 50 to 79 years at baseline ( mean age , 63.6 years ) who had previously undergone hysterectomy were r and omized to receive CEE  , 0.625 mg/d , or  placebo at 40 US clinical centers beginning in 1993 . The trial was terminated early after 6.8 years of follow-up ( planned duration , 8.5 years ) . This report includes final , central ly adjudicated results for the primary efficacy outcome ( myocardial infa rct ion or coronary death ) , secondary coronary outcomes , and subgroup analyses . RESULTS During the active intervention period , 201 coronary events were confirmed among women assigned to receive CEE compared with 217 events among women assigned to receive placebo ( hazard ratio , 0.95 ; nominal 95 % confidence interval , 0.79 - 1.16 ) . Among women aged 50 to 59 years at baseline , the hazard ratio for the primary outcome was 0.63 ( nominal 95 % confidence interval , 0.36 - 1.08 ) . In that age group , coronary revascularization was less frequent among women assigned to receive CEE ( hazard ratio , 0.55 ; nominal 95 % confidence interval , 0.35 - 0.86 ) , as were several composite outcomes , which included the primary outcome and coronary revascularization ( hazard ratio , 0.66 ; nominal 95 % confidence interval , 0.44 - 0.97 ) . CONCLUSIONS Conjugated equine estrogens provided no overall protection against myocardial infa rct ion or coronary death in generally healthy postmenopausal women during a 7-year period of use . There was a suggestion of lower coronary heart disease risk with CEE among women 50 to 59 years of age at baseline
We found high quality evidence that hormone therapy in both primary and secondary prevention conferred no protective effects for all-cause mortality , cardiovascular death , non-fatal myocardial infa rct ion , angina , or revascularisation .
There was no strong evidence of effect on risk of stroke in this group .
Our review findings provide strong evidence that treatment with hormone therapy in post-menopausal women overall , for either primary or secondary prevention of cardiovascular disease events has little if any benefit and causes an increase in the risk of stroke and venous thromboembolic events
BACKGROUND Evidence from systematic review s of observational studies suggests that hormone therapy may have beneficial effects in reducing the incidence of cardiovascular disease events in post-menopausal women , however the results of r and omised controlled trials ( RCTs ) have had mixed results .
This is an up date d version of a Cochrane review published in 2013 .
OBJECTIVES To assess the effects of hormone therapy for the prevention of cardiovascular disease in post-menopausal women , and whether there are differential effects between use in primary or secondary prevention .
Secondary aims were to undertake exploratory analyses to ( i ) assess the impact of time since menopause that treatment was commenced ( ≥ 10 years versus < 10 years ) , and where these data were not available , use age of trial participants at baseline as a proxy ( ≥ 60 years of age versus < 60 years of age ) ; and ( ii ) assess the effects of length of time on treatment .