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 long-term effect of oral and percutaneous estradiol on plasma renin substrate and blood pressure.
The long-term effect of percutaneous and oral estrogen replacement therapy on blood pressure , plasma renin substrate , and serum estrogens was examined in a 2 year placebo-controlled study with 110 early postmenopausal women . The women were allocated to four treatment groups : ( 1 ) oral cyclical combination of 2 mg estradiol valerate and cyproterone acetate , ( 2 ) oral placebo , ( 3 ) percutaneous 17 beta-estradiol , supplemented by 200 mg oral progesterone during the second year , or ( 4 ) percutaneous placebo cream .  Systolic and diastolic blood pressure remained unchanged in both hormone treatment groups , whereas the diastolic blood pressure tended to increase in both placebo groups . Plasma renin substrate increased during oral treatment with estradiol , but remained unchanged with percutaneous estradiol . No correlation was found between blood pressure and plasma renin substrate . During percutaneous administration of estradiol , the serum concentrations of estrone and estradiol continued to rise after 3 months and reached a plateau at 6 months of therapy . Serum estrone but not estradiol showed the same pattern during oral estradiol therapy . No further changes in any of the measured variables were observed in the women treated with percutaneous estradiol after addition of cyclical oral progesterone . We conclude that both oral and percutaneous treatment with estradiol may provide protection against the age-related increase in diastolic blood pressure observed in early postmenopausal women , and that the metabolic steady state is not attained until after 3 months of estradiol therapy
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 .