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 progestogen and progestogen type on hemostasis measures in postmenopausal women: the Postmenopausal Estrogen/Progestin Intervention (PEPI) Study
Objective : The contribution of progestogen therapy or progestogen type to risks and benefits of estrogen treatment is inadequately characterized . We examined the effect of conjugated equine estrogens ( CEE ) with and without concomitant progestogen treatments on changes in hemostasis measures among Postmenopausal Estrogen/Progestin Intervention participants . Design : Postmenopausal Estrogen/Progestin Intervention was a clinical trial that r and omized 875 postmenopausal women to one of five arms : placebo , CEE alone , CEE with cyclic micronized progesterone ( MP ) , CEE with cyclic medroxyprogesterone acetate ( MPA ) , and CEE with continuous MPA . Twelve hemostasis assays were measured in a sub study at baseline and 12 and 36 months . Using 12- and 36-month changes in hemostasis measures , we calculated change ratios for two comparisons of active treatments : CEE+MPA versus CEE and CEE+MPA versus CEE+MP . Results : Hemostasis measures were available for 288 women . Compared with women assigned to CEE alone , 12-month increases in factor VIIc and protein C among women assigned to CEE+MPA were relatively smaller ( ratios : 0.94 [ 95 % CI : 0.89 - 0.98 ] and 0.96 [ 95 % CI : 0.92 - 1.00 ] ) , respectively . Compared with women assigned to CEE+MP , women assigned to CEE+MPA had smaller increases in factor VIIc and larger decreases in plasminogen activator inhibitor-1 antigen at 12 months ( ratios : 0.94 [ 95 % CI : 0.90 - 0.98 ] and 0.70 [ 95 % CI : 0.53 - 0.93 ] , respectively ) . Thirty-six month ratios were similar to these . Women assigned to CEE+MPA had smaller increases in protein C than those assigned CEE+MP at 36 months only ( ratio : 0.95 [ 95 % CI : 0.91 - 0.99 ] ) . No other associations were significant . Conclusions : We found modest yet significant differences in hemostasis measure changes when comparing progestogen use and progestogen type in postmenopausal women using CEE
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 .