title: The long-term impact of 2-3 years of hormone replacement therapy on cardiovascular mortality and atherosclerosis in healthy women.
abstract: OBJECTIVE
  The effect of hormone replacement therapy (HRT) on cardiovascular risk is intensely debated. The aim of this study was to investigate the long-term effects of HRT given for a few years on all-cause and cardiovascular mortality and the severity of atherosclerosis.
  
  
  METHODS
  This analysis was based on a cohort of 1,458 postmenopausal women (55.8 +/- 6.1 years old) who previously participated in a number of randomized, placebo-controlled, clinical trials assessing the efficacy of 2-3 years of therapy with various estrogen plus progestin combinations for preventing bone loss. Women were followed on average for 9.8 years and came for a follow-up visit. Outcome variables were all-cause and cardiovascular mortality and the severity of atherosclerosis, as estimated by semi-quantitative scoring of vascular calcification in the lumbar aorta on lateral radiographs.
  
  
  RESULTS
  A total of 174 women died during the observation period. All-cause mortality was decreased by 30% in the HRT+ group compared with the HRT- group (hazard ratio (HR) 0.70; 95% confidence interval (CI) 0.50-0.97) after adjusting for age, body mass index and smoking. Under the same conditions, similar results characterized mortality from cardiovascular disease (n = 61 deaths; 35.1% of all deaths) and coronary heart disease (n = 39 deaths; 22.4% of all deaths), which were decreased by 46% (HR 0.54, 95% CI 0.29-0.98, p = 0.045) and 53% (HR 0.47, 95% CI 0.21-1.03, p = 0.062), respectively. Furthermore, the mean severity score of aortic calcification at follow-up was significantly lower in hormone-treated compared to non-treated women (p < 0.0001).
  
  
  CONCLUSIONS
  Women who receive 2-3 years of HRT after menopause do not have increased all-cause mortality, and results of the present study suggest relative cardiovascular benefits compared to those who had not used hormones.
authors.affiliation: Center for Clinical and Basic Research, Ballerup, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Alexandersen
authors.forename: L B
authors.initials: LB
authors.lastname: Tankó
authors.forename: Y Z
authors.initials: YZ
authors.lastname: Bagger
authors.forename: G
authors.initials: G
authors.lastname: Qin
authors.forename: C
authors.initials: C
authors.lastname: Christiansen
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D002423:Cause of Death; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D004966:Estrogens, Conjugated (USP) / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D045167:Progesterone Congeners / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis
chemical_list: D004966:Estrogens, Conjugated (USP); D045167:Progesterone Congeners