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 .
Hot flushes, coronary heart disease, and hormone therapy in postmenopausal women
Objective : The aim of this study was to examine interactions between hot flushes , estrogen plus progestogen therapy ( EPT ) , and coronary heart disease ( CHD ) events in postmenopausal women with CHD . Methods : We analyzed data from the Heart and Estrogen/Progestin Replacement Study , a r and omized , placebo-controlled trial of 0.625 mg conjugated equine estrogens plus 2.5 mg medroxyprogesterone acetate in 2,763 postmenopausal women with CHD .  Hot flushes were assessed at baseline using self-administered question naires ; women reporting bothersome hot flushes " some " to " all " of the time were considered to have clinical ly significant flushing . Cox regression models were used to examine the effect of EPT on risk of CHD events among women with and without significant flushing at baseline . Results : The mean age of participants was 66.7 ± 6.8 years , and 89 % ( n = 2,448 ) were white . Sixteen percent ( n = 434 ) of participants reported clinical ly significant hot flushes at baseline . Among women with baseline flushing , EPT increased risk of CHD events nine-fold in the first year compared with placebo ( hazard ratio = 9.01 ; 95 % CI , 1.15 - 70.35 ) ; among women without baseline flushing , treatment did not significantly affect CHD event risk in the first year ( hazard ratio = 1.32 ; 95 % CI , 0.86 - 2.03 ; P = 0.07 for interaction of hot flushes with treatment ) . The trend toward differential  effects of EPT on risk for CHD among women with and without baseline flushing did not persist after the first year of treatment . Conclusions : Among older postmenopausal women with CHD  , EPT may increase risk of CHD events substantially in the first year of treatment among women with clinical ly significant hot flushes but not among those without hot flushes
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 .