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 .
Genetic variation in estrogen receptor, C-reactive protein and fibrinogen does not predict the plasma levels of inflammation markers after longterm hormone replacement therapy.
Markers of inflammation , such as C-reactive protein ( CRP ) and fibrinogen , are associated with the risk of atherothrombosis . Plasma levels of these markers of inflammation are affected by hormone replacement therapy ( HRT ) and modulated by smoking . We studied whether genetic variation in the estrogen receptor- 1 ( ESR1 ) , CRP and fibrinogen-beta genes influences the plasma levels of inflammation markers after HRT .  Plasma CRP and fibrinogen were measured after five years follow-up in healthy postmenopausal women ( per- protocol group ) who were r and omised to hormone therapy ( n=187 ) or no treatment ( n=249 ) . The effect of HRT , smoking and genetic variations in ESR1 ( PvuII and XbaI ) , CRP ( 1444C/T ) and fibrinogen-beta ( FGB , -455G/A ) were determined . The plasma concentration of CRP was higher in the HRT group than in the control group ( 2.03 mg/l and 1.41 mg/l , respectively ; p < 0.001 ) , while the concentration of fibrinogen was lower in the HRT group than in the control group ( 3.02 g/l and 3.20 g/l , respectively ; p < 0.001 ) , indicating that it is unlikely that inflammation is the common underlying pathway . There was a significant interaction between smoking and HRT  on the fibrinogen ( p=0.02 ) , but not on the CRP concentration ( n.s . ) . Genetic polymorphisms in ESR1 , CRP and fibrinogen were not associated with an effect of HRT on the CRP and fibrinogen plasma levels , and no significant interaction with smoking was observed . In conclusion , higher plasma levels of CRP and lower plasma levels of fibrinogen were observed in women using HRT ;  however , genetic polymorphisms in ESR1 , CRP and FGB were not associated with these effects of HRT
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 .