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 postmenopausal hormone therapy on lipoprotein(a) concentration. PEPI Investigators. Postmenopausal Estrogen/Progestin Interventions.
BACKGROUND Postmenopausal hormone therapy has been reported to decrease levels of lipoprotein (Lp)(a ) in cross-sectional studies and small or short-term longitudinal studies . We report findings from a large , prospect i ve , placebo-controlled clinical trial that allows a broad characterization of these effects for four regimens of hormone therapy . METHODS AND RESULT The Postmenopausal Estrogen/Progestin Interventions study was a 3-year , placebo-controlled , r and omized clinical trial to assess the effect of hormone regimens on cardiovascular disease risk factors in postmenopausal women 45 to 65 years of age . The active regimens were conjugated equine estrogens therapy at 0.625 mg daily , alone or in combination with each of three regimens of progestational agents : medroxyprogesterone acetate ( MPA ) at 2.5 mg daily ( ie , continuous MPA ) , MPA at 10 mg days 1 to 12 ( ie , cyclical MPA ) , and micronized progesterone at 200 mg days 1 to 12 .  Plasma levels of Lp(a ) were measured at baseline ( n = 366 ) , 12 months ( n = 354 ) , and 36 months ( n = 342 ) . Assignment to hormone therapy result ed in a 17 % to 23 % average drop in Lp(a ) concentrations relative to placebo ( P<.0001 ) , which was maintained across 3 years of follow-up . No significant differences were observed among the four active arms . Changes in Lp(a ) associated with hormone therapy were positively correlated with changes in LDL cholesterol , total cholesterol , apolipoprotein B , and fibrinogen levels and were similar across subgroups defined by age , weight , ethnicity , and prior hormone use . CONCLUSIONS Postmenopausal estrogen therapy , with or without concomitant progestin regimens , produces consistent and sustained reductions in plasma Lp(a ) concentrations
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 .