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 .
Effects of Conventional or Lower Doses of Hormone Replacement Therapy in Postmenopausal Women
Objective —The effects of hormone replacement therapy ( HRT ) can affect many aspects relevant to cardiovascular disease , including vasomotor function , inflammation , and hemostasis . Recent studies have demonstrated that current doses of HRT exert a mixture of both protective and adverse effects . In the current study , we compared the effects of lower doses of HRT ( L-HRT ) and conventional doses of HRT ( C-HRT ) on a variety of relevant cardiovascular parameters . Methods and Results —This r and omized , double-blind , crossover study included 57 women who received micronized progesterone 100 mg with either conjugated equine estrogen 0.625 mg ( C-HRT ) or 0.3 mg ( L-HRT ) daily for 2 months .  L-HRT showed comparable effects to C-HRT on high-density lipoprotein cholesterol and triglyceride levels , but not on low-density lipoprotein cholesterol levels .  C-HRT and L-HRT significantly improved the percent flow-mediated dilator response to hyperemia from baseline values ( both P < 0.001 ) by a similar degree ( P = 0.719 ) . C-HRT significantly increased high-sensitivity C-reactive protein ( hsCRP ) levels from baseline values ( P < 0.001 ) ; however , L-HRT did not significantly change hsCRP ( P = 0.874 ) . C-HRT and L-HRT significantly decreased antithrombin III from baseline values ( P < 0.001 and P = 0.042 , respectively ) . C-HRT significantly increased prothrombin fragment 1 + 2 ( F1 + 2 ) from baseline values ( P < 0.001 ) ; however , L-HRT did not significantly change F1 + 2 ( P = 0.558 ) . Of interest , the effects of C-HRT and L-HRT on hsCRP , antithrombin III , and F1 + 2 were significantly different ( all P < 0.001 ) . C-HRT and L-HRT significantly reduced plasma PAI-1 antigen levels from baseline values ( P = 0.002 and P = 0.038 , respectively ) to a similar degree ( P = 0.184 ) . Conclusions —Compared with C-HRT , L-HRT has comparable effects on lipoproteins , flow-mediated dilation , and PAI-1 antigen levels . However , L-HRT did not increase hsCRP or F1 + 2 levels , and it decreased antithrombin III less than C-HRT
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 .