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 .
Brain volumes, cognitive impairment, and conjugated equine estrogens.
BACKGROUND Postmenopausal conjugated equine estrogens ( CEE ) therapies increase the risk of  cognitive impairment in women aged 65 years or older and are associated with smaller regional brain volumes ; however , the link between these two phenomena has not been established . METHODS St and ardized magnetic resonance imaging was performed on 1,403 women , 1 - 4 years after they had participated in r and omized placebo-controlled clinical trials of CEE-based therapies . Women included in this report were aged 65 - 80 years and free of dementia and mild cognitive impairment ( MCI ) when originally enrolled in the trials , which lasted an average of 4 - 6 years and were conducted at 14 academic U.S. medical centers . The associations that regional brain volumes and ischemic lesion volumes had with the development of cognitive impairment ( i.e. , dementia or MCI ) were contrasted between treatment groups using analyses of covariance . RESULTS Fifty-three women developed MCI or probable dementia during follow-up . Among women who had been prescribed CEE-based therapies , cognitive impairment was associated with relatively smaller hippocampal ( p = .0002 ) and total brain volumes ( p = .03 ) . Qualitatively , these associations appeared to be independent of their level of pretreatment cognitive function . Among women who had been prescribed placebo , these relationships were not evident ; instead , cognitive impairment was associated with greater ischemic lesion volume in the frontal lobe ( p = .007 ) and overall ( p = .02 ) . CONCLUSION A mechanism by which CEE-based postmenopausal hormone therapy induces cognitive impairment appears to be through increased brain atrophy
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 .