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Got It, Hide thisBoardman HM, Hartley L, Eisinga A, et al. Hormone therapy for preventing cardiovascular disease in post-menopausal women. Cochrane Database Syst Rev. 2015;3:CD002229.
In postmenopausal women with or without cardiovascular disease, does hormone therapy reduce the risk of cardiovascular events, such as clots in the veins or lungs, heart attacks, and strokes?
Women are more likely to develop cardiovascular disease after menopause than before menopause. Hormone therapy is often used to control menopausal symptoms. It is thought that hormone therapy might also prevent cardiovascular disease in postmenopausal women.
The researchers did a systematic review based on studies available up to February 2014.
They found 19 randomized controlled trials with 40,410 postmenopausal women (average age 64 years).
Key features of the trials were:
The quality of evidence was moderate to high.
Postmenopausal women with no previous cardiovascular disease
Compared with placebo, hormone therapy:
Postmenopausal women with previous cardiovascular disease
Compared with placebo, hormone therapy:
In postmenopausal women with or without cardiovascular disease, hormone therapy does not reduce risk of death and increases risk of cardiovascular events.
Outcomes | Number of trials (number of women) | Rate of events with hormone therapy | Rate of events with placebo | Absolute effect of hormone therapy | |
Women with no previous cardiovascular disease | |||||
Death | 8 trials (34,422 women) | 3.2% | 3.2% | No effect | |
Death due to cardiovascular causes | 3 trials (28,353 women) | 0.7% | 0.8% | No effect* | |
Stroke | 4 trials (28,719 women) | 2.3% | 1.8% | About 5 more woman out of 1000 had a stroke | |
Clots in veins (venous thromboembolism) | 6 trials (33,477 women) | 2% | 1% | About 10 more woman out of 1000 had a venous thromboembolism | |
Clots in lungs (pulmonary embolism) | 3 trials (31,732 women) | 0.9% | 0.5% | About 4 more women out of 1000 had a pulmonary embolism | |
Women with previous cardiovascular disease | |||||
Death | 7 trials (5445 women) | 8.8% | 8.4% | No effect* | |
Death due to cardiovascular causes | 6 trials (5259 women) | 4.5% | 4.5% | No effect | |
Stroke | 5 trials (5172 women) | 7.1% | 6.5% | No effect* | |
Clots in the veins (venous thromboembolism) | 6 trials (4399 women) | 2.3% | 1.1% | About 12 more women out of 1000 had a clot in the veins | |
Clots in the lungs (pulmonary embolism) | 3 trials (3920 women) | 1% | 0.4% | About 6 more women out of 1000 had a clot in the lungs | |