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 .
Effect of postmenopausal hormone replacement on atherosclerosis in femoral arteries.
OBJECTIVES On the basis of epidemiological and experimental data , it has been supposed that hormone replacement therapy ( HRT ) inhibits atherosclerosis in postmenopausal women . This r and omized controlled trial examined whether 1 mg 17beta-estradiol daily , combined cyclically with 0.025 mg gestodene in every month ( HRT 1 ) , or in every third month ( HRT 2 ) slows the increase of intima-media thickness in femoral arteries compared with no HRT . METHODS Healthy postmenopausal women ( n=321 ) with an increased risk for future vascular disease as indicated by > 1 mm of intima-media thickness in the carotid arteries were equally r and omized to one of the three groups for 48 weeks .  Ultrasound scans of femoral arteries were recorded at study start and study end , together with a thorough clinical examination and laboratory work-up . RESULTS Complete scans were obtained in 260 of the 264 subjects who participated until study end .  Mean maximum intima-media thickness of four femoral artery segments ( common and superficial , both sides ) was 0.93+/-0.37 mm ( mean+/-S.D. ) at study start . It increased by 0.02+/-0.05 , 0.02+/-0.05 , and 0.03+/-0.05 mm in the HRT 1 , HRT 2 and no HRT groups , respectively ( HRT 1 versus no HRT , HRT 2 versus no HRT ; both P>0.2 ) . Compared with no HRT , HRT significantly lowered follicle stimulating hormone , low-density lipoprotein cholesterol , and fibrinogen . CONCLUSIONS In this 1-year trial , irrespective of the progestogen dose used , HRT with 1 mg 17 beta-estradiol did not inhibit progression of femoral artery atheroslerosis in postmenopausal women with sub clinical vascular 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 .