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 .
Estrogen Plus Progestin and the Risk of Peripheral Arterial Disease: The Women’s Health Initiative
Background —Observational studies have reported less frequent carotid atherosclerosis in healthy women taking postmenopausal hormone therapy . Estrogen with progestin did not reduce peripheral arterial events among women with preexisting coronary heart disease . This analysis evaluates clinical peripheral arterial disease among generally healthy women in the Women ’s Health Initiative r and omized trial of estrogen plus progestin . Methods and Results —The Estrogen Plus Progestin trial assigned 16 608 postmenopausal women , mean age 63.3±7.1 years , to daily conjugated estrogens ( 0.625 mg ) with medroxyprogesterone acetate ( 2.5 mg ) or placebo and documented health outcomes over an average of 5.6 years of follow-up . Hospitalization for peripheral arterial disease was infrequent , with annualized rates of 0.08 % , 0.06 % , and 0.02 % for carotid disease , lower extremity arterial disease , and abdominal aortic aneurysm , respectively . The incidence of peripheral arterial events did not differ between treatment groups ( hazard ratio [ HR ] 0.89 , 95 % confidence interval 0.63 , 1.25 ) . The risk was slightly greater among women assigned to active estrogen with progestin in years 1 ( HR 1.33 ) and 2 ( HR 1.27 ) , and was slightly lower in later years ( HR 0.85 and 0.87 in years 5 and ≥6 ) . Among adherent participants , the hazard ratio for peripheral arterial events was 1.23 ( 95 % confidence interval 0.79 , 1.91 ) over the 5.6 years of follow up . Subgroup analysis identified no significant interactions between estrogen with progestin and baseline characteristics with regard to peripheral arterial disease risk . Conclusions —Among generally healthy postmenopausal women , conjugated estrogens with progestin did not confer protection against peripheral arterial disease
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 .