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 .
A case-control study of myocardial infarction in relation to use of estrogen supplements.
Observational epidemiologic studies suggest that the incidence of cardiovascular disease is reduced by about 50 % in users of unopposed estrogens , but the reduction may have been overestimated because of a greater tendency for women at lower risk to use estrogens . To minimize bias due to such behavior , the authors conducted a case-control study of first myocardial infa rct ion among Massachusetts women aged 45 - 69 years during 1986 - 1990 , in which each of 858 cases was age-matched with a control from the same geographic area , and important correlates of  estrogen use and myocardial infa rct ion were controlled by conditional logistic regression . The estimated relative risk was 0.9 for ever use of unopposed estrogen ( 95 % confidence interval 0.7 - 1.2 ) ; the estimate decreased with increasing duration of use to 0.6 for 5 or more years of use ( p for trend = 0.08 ) . The association with long-term use was stronger for recent use ( p for trend < 0.05 ) than for past use ( p for trend = 0.86 ) . There were insufficient data to evaluate estrogens taken together with progestins . The results suggest that unopposed estrogen use may reduce the risk of first myocardial infa rct ion , that the reduction is related to the duration and recency of use , and that it may be smaller than previously believed . Despite efforts to control confounding , observational studies can not rule out the possibility that a tendency for women at lower risk for myocardial infa rct ion to use estrogens has contributed to the reduced risk in estrogen users , and r and omized trials are needed
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 .