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 continuous estrogen and estrogen-progestin replacement regimens on cardiovascular risk markers in postmenopausal women.
OBJECTIVE To evaluate the influence of 2 continuous combined estrogen-progestin replacement products , compared with unopposed estrogen and placebo , on cardiovascular risk markers in postmenopausal women in a r and omized , double-blind , placebo-controlled trial . METHODS Two hundred seventy healthy postmenopausal women were r and omly assigned to 1 of 4 treatment groups : placebo , unopposed 17-beta estradiol ( 1 mg ) , 1 mg of 17-beta estradiol with 0.25 mg of norethindrone acetate , or 1 mg of 17-beta estradiol with 0.5 mg of norethindrone acetate . The primary outcome variable was change from baseline in low-density lipoprotein cholesterol concentration . Additional outcome variables included changes in other serum lipid levels , hemostatic variables , and indicators of carbohydrate metabolism . RESULTS The low-density lipoprotein cholesterol level was reduced to a similar degree in all groups receiving active treatment ( 10%-14 % from baseline ; P = .001 for 17-beta estradiol with 0.5 mg of norethindrone acetate , P = .004 for 17-beta estradiol with 0.25 mg of norethindrone acetate , and P = . 001 for 1 mg of 17-beta estradiol vs placebo ) . Compared with unopposed 17-beta estradiol , 17-beta estradiol with 0.5 mg of norethindrone acetate enhanced the reductions in total cholesterol and apolipoprotein B levels ( P<.01 vs 17-beta estradiol ) . 17-beta Estradiol plus norethindrone blunted or reversed the increases in levels of high-density lipoprotein cholesterol , apolipoprotein A-I , and triglycerides produced by 17-beta estradiol alone . Effects of 17-beta estradiol plus norethindrone on hemostatic variables were similar to those of 17-beta estradiol except for factor VII activity , which was significantly reduced with 17-beta estradiol combined with 0.25 mg ( P<.01 ) and 0.5 mg ( P<.05 ) of norethindrone acetate . 17-beta Estradiol plus norethindrone appeared to blunt reductions in C-peptide and insulin levels produced by unopposed 17-beta estradiol but did not elevate these values compared with placebo . CONCLUSIONS 17-beta Estradiol plus norethindrone produced favorable changes in most cardiovascular risk markers evaluated and has a profile distinct from that of unopposed 17-beta estradiol . The impact of these differences on cardiovascular events warrants investigation . Arch Intern Med . 2000;160:3315 - 3325
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 .