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 .
The risk of myocardial infarction associated with the combined use of estrogens and progestins in postmenopausal women.
BACKGROUND While observational studies have suggested that unopposed estrogens reduce the incidence of coronary disease in postmenopausal women , there are few data on the effect of combined therapy with estrogens and progestins -- a regimen adopted in recent years to minimize the risk of endometrial hyperplasia and cancer . In clinical trials , the addition of progestins has an adverse effect on serum lipid levels , and these lipid effects have raised the question of whether combined estrogen-progestin therapy increases the risk of coronary disease compared with the use of estrogen alone . METHODS We conducted a population -based , case-control study among enrollees of Group Health Cooperative of Puget Sound . Cases were postmenopausal women who sustained an incident fatal or nonfatal myocardial infa rct ion in 1986 through 1990 . Controls were a stratified r and om sample of female Group Health Cooperative enrollees frequency matched to the cases by age and calendar year . We review ed the medical records of the 502 cases and 1193 controls and conducted brief telephone interviews with consenting survivors . The health maintenance organization 's computerized pharmacy data base was used to ascertain the use of postmenopausal hormones . For the primary analysis of current use , we classified women into one of three groups : ( 1 ) nonusers of hormones ; ( 2 ) users of estrogens alone ; or ( 3 ) users of combined therapy including both estrogens and progestins .  Each group of hormone users was compared with nonusers . RESULTS After adjustment for potential confounding factors , the risk ratio of myocardial infa rct ion associated with current use of estrogens alone was 0.69 ( 95 % confidence interval , 0.47 to 1.02 ) ; and the risk ratio of myocardial infa rct ion associated with current use of combined therapy was 0.68 ( 95 % confidence interval , 0.38 to 1.22 ) . Duration of combined-therapy use was relatively short , averaging less than 2 years in cases and controls . CONCLUSIONS In this case-control study , the reduced risk of myocardial infa rct ion associated with the use of estrogens alone was consistent with previous observational studies . Although the 95 % confidence interval only excluded a risk above 1.22 , the current use of combined therapy was not associated with an adverse effect on the incidence of myocardial infa rct ion in postmenopausal women
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 .