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 estrogen replacement on the progression of coronary-artery atherosclerosis.
BACKGROUND Heart disease is a major cause of illness and death in women . To underst and better the role of estrogen in the treatment and prevention of heart disease , more information is needed about its effects on coronary atherosclerosis and the extent to which concomitant progestin therapy may modify these effects . METHODS We r and omly assigned a total of 309 women with angiographically verified coronary disease to receive 0.625 mg of conjugated estrogen per day , 0.625 mg of conjugated estrogen plus 2.5 mg of medroxyprogesterone acetate per day , or placebo . The women were followed for a mean ( + /-SD ) of 3.2+/-0.6 years . Base-line and follow-up coronary angiograms were analyzed by quantitative coronary angiography . RESULTS Estrogen and estrogen plus medroxyprogesterone acetate produced significant reductions in low-density lipoprotein cholesterol levels ( 9.4 percent and 16.5 percent , respectively ) and significant increases in high-density lipoprotein cholesterol levels ( 18.8 percent and 14.2 percent , respectively ) ; however , neither treatment altered the progression of coronary atherosclerosis . After adjustment for measurements at base line , the mean ( + /-SE ) minimal coronary-artery diameters at follow-up were 1.87+/-0.02 mm , 1.84+/-0.02 mm , and 1.87+/-0.02 mm in women assigned to estrogen , estrogen plus medroxyprogesterone acetate , and placebo , respectively . The differences between the values for the two active-treatment groups and the value for the placebo group were not significant . Analyses of several secondary angiographic outcomes and subgroups of women produced similar results . The rates of clinical cardiovascular events were also similar among the treatment groups . CONCLUSIONS Neither estrogen alone nor estrogen plus medroxyprogesterone acetate affected the progression of coronary atherosclerosis in women with established disease . These results suggest that such women should not use estrogen replacement with an expectation of cardiovascular benefit
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 .