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 .
Combined therapy with estrogen and etidronate has an additive effect on bone mineral density in the hip and vertebrae: four-year randomized study.
BACKGROUND Administration of estrogen or etidronate has been shown to increase bone mineral density in postmenopausal women . This 4-year , prospect i ve , r and omized study was carried out to monitor any added beneficial effect on bone mineral density when hormone-replacement therapy ( HRT ) was combined with etidronate . PATIENTS AND METHODS Fifty-eight early postmenopausal women attending metabolic bone disease outpatient clinics were r and omly allocated into four treatment groups and monitored for up to 4 years . All patients received 1.0 g/d of elemental calcium . In addition , group 1 received percutaneously administered HRT ( n = 15 ) ; group 2 , intermittent cyclical etidronate ( ICE ) ( n = 14 ) ; group 3 , HRT and ICE ( n = 15 ) ; and group 4 , calcium alone ( n = 14 ) . The bone mineral density ( measured by dual-energy x-ray absorptiometry ) , biochemical variables of bone turnover , including bone-specific alkaline phosphatase , and urinary hydroxyproline : creatinine ratios were measured before treatment and at 2 and 4 years after treatment . RESULTS In patients who received the combined therapy , bone mineral density was increased in the vertebrae by 10.9 % ( P < 0.001 ) and in the femora by 7.25 % ( P < 0.001 ) at 4 years . For patients treated with ICE , the increase was 6.79 % ( P < 0.001 ) and 1.20 % ( P < 0.05 ) , and with HRT , 6.78 % ( P < 0.001 ) and 4.01 % ( P < 0.01 ) in the vertebrae and femora , respectively . The group treated with calcium alone lost 3.81 % ( P < 0.01 ) and 4.96 % ( P < 0.01 ) of bone mineral density in vertebrae and femora . Patients who received no specific therapy lost 8.58 % ( P < 0.01 ) from vertebrae , and 7.83 % ( P < 0.01 ) from the femora over 4 years . Patients who received combined therapy had significantly higher bone mineral density in both vertebrae ( P < 0.05 ) and femora ( P < 0.01 ) , in comparison to patients who were treated with HRT , or ICE , alone . Three of 9 patients ( 33 % ) in the ICE group developed osteomalacia , as shown by bone histomorphometry , whereas in women who received combined HRT and ICE therapies , none of the 11 patients tested had evidence of bone mineralization defects . CONCLUSION This 4-year , prospect i ve , r and omized study in early postmenopausal women showed an additive effect of ICE and HRT on the bone mineral density in both vertebrae and the hip . Furthermore , the combined therapy prevented the occurrence of osteomalacia associated with etidronate . This is the first study to demonstrate the effects of etidronate in early postmenopausal women , and the additive beneficial effects of HRT and ICE on bone mineral density
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 .