[From the Cochrane Library: postmenopausal hormone replacement therapy (HRT) does not protect women against cardiovascular disease but does lead to an increased risk of venous thromboembolism].
Observational studies in the early nineteen-nineties have strongly suggested that hormone replacement therapy (HRT) has benefits for reducing cardiovascular events in postmenopausal women. A recent Cochrane systematic review assessed the effects of HRT in primary and secondary prevention of cardiovascular disease in postmenopausal women from ten randomized placebo-controlled trials published in the last decade. No protective effect of HRT was seen for any of the cardiovascular outcomes assessed. In contrast, higher risks of venous thromboembolic events, pulmonary embolus and stroke were found in postmenopausal women randomized to HRT compared to a placebo. Initiating HRT in postmenopausal women (with or without cardiovascular disease) for the sole reason of preventing cardiovascular disease should not be recommended. Further, in the case of other risk factors for venous thromboembolic events, the use of HRT for preventive purposes should be discouraged.
Academisch Medisch Centrum/Universiteit van Amsterdam, Dutch Cochrane Centre, J1B-108, Postbus 22.660, 1100 DD Amsterdam. j.v.hamerlynck@amc.uva.nl
J V Th H
JV
Hamerlynck
S
S
Middeldorp
R J P M
RJ
Scholten
D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control; D016001:Confidence Intervals; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013923:Thromboembolism / Q000209:etiology*