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 .
Hormone therapy and the progression of coronary-artery atherosclerosis in postmenopausal women.
BACKGROUND In postmenopausal women with coronary artery disease , conjugated equine estrogen with or without continuous administration of medroxyprogesterone acetate has failed to slow the progression of atherosclerosis . Whether 17beta-estradiol ( the endogenous estrogen molecule ) alone or administered sequentially with medroxyprogesterone acetate can slow the progression of atherosclerosis is unknown . METHODS We conducted a double-blind , placebo-controlled trial in 226 postmenopausal women ( mean age , 63.5 years ) who had at least one coronary-artery lesion . Participants were r and omly assigned to usual care ( control group ) , estrogen therapy with micronized 17beta-estradiol alone ( estrogen group ) , or 17beta-estradiol plus sequentially administered medroxyprogesterone acetate ( estrogen-progestin group ) . In all patients the low-density lipoprotein ( LDL ) cholesterol level was reduced to a target of less than 130 mg per deciliter . The primary outcome was the average per-participant change between base-line and follow-up coronary angiograms in the percent stenosis measured by quantitative coronary angiography . RESULTS After a median of 3.3 years of follow-up , the mean ( + /-SE ) change in the percent stenosis in the 169 participants who had a pair of matched angiograms was 1.89+/-0.78 percentage points in the control group , 2.18+/-0.76 in the estrogen group , and 1.24+/-0.80 in the estrogen-progestin group ( P=0.66 for the comparison among the three groups ) . The mean difference in the percent stenosis between the estrogen group and the control group was 0.29 percentage point ( 95 percent confidence interval , -1.88 to 2.46 ) , and the mean difference between the estrogen-progestin group and the control group was -0.65 ( 95 percent confidence interval , -2.87 to 1.57 ) . CONCLUSIONS In older postmenopausal women with established coronary-artery atherosclerosis , 17beta-estradiol either alone or with sequentially administered medroxyprogesterone acetate had no significant effect on the progression of atherosclerosis
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 .