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 Therapy on Glucose and Insulin Concentrations
OBJECTIVE To characterize the long-term impact of four hormone therapy regimens on insulin and glucose concentrations measured during a st and ard oral glucose tolerance test . RESEARCH DESIGN AND METHODS The Postmenopausal Estrogen/Progestin Intervention Study was a 3-year placebo-controlled r and omized trial to assess effects of four hormone regimens  on  cardiovascular risk factors .  This efficacy analysis describes glucose and insulin concentrations from 788 adherent women at baseline and at 1 and 3 years ' postr and omization RESULTS When compared with women taking placebo , those taking conjugated equine estrogen ( CEE ) at 0.625 mg/day with or without a progestational agent had mean fasting insulin levels that were 16.1 % lower , mean fasting glucose levels 2.2 mg/dl lower , and mean 2-h glucose levels 6.4 mg/dl higher ( each nominal P < 0.05 ) . No significant differences were apparent between women taking CEE only versus the three progestin regimens : medroxyprogesterone acetate ( MPA ) at 2.5 mg daily ( continuous MPA ) , MPA at 10 mg on days 1–12 ( cyclical MPA ) , and micronized progesterone ( MP ) ( cyclical ) at 200 mg on days 1–12 . The impact of hormone therapy on insulin and glucose depended on baseline levels of fasting insulin and 1-h glucose ( P < 0.05 ) . However , the treatment effects on carbohydrate metabolism appeared to be consistent across participant subgroups formed by lifestyle , clinical , and demographic characteristics . CONCLUSIONS Oral hormone therapy involving 0.625 mg/day of CEE may modestly decrease fasting levels of insulin and glucose . Postchallenge glucose concentrations are increased , however , which may indicate delayed glucose clearance
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 .