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Menopausal hormone therapy and cardiovascular protection: state of the data 2003

Nanette K Wenger1

  • 1Emory University School of Medicine, Atlanta, Georgia, USA.

Journal of the American Medical Women'S Association (1972)
|December 3, 2003
PubMed

Insights

Menopausal hormone therapy does not prevent cardiovascular events and may increase risks. Focus on proven heart health strategies like diet, exercise, and smoking cessation for women.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Women's Health

Background:

  • Estrogen therapy has biologically plausible mechanisms for cardiac protection.
  • Observational studies suggested cardiovascular benefits of hormone therapy.

Purpose of the Study:

  • To evaluate the cardiovascular outcomes of menopausal hormone therapy in randomized clinical trials.
  • To assess the risks and benefits of hormone therapy for primary and secondary cardiovascular prevention.

Main Methods:

  • Analysis of well-designed and conducted primary and secondary prevention randomized clinical trials.
  • Review of clinical trial data on menopausal hormone therapy and cardiovascular events.

Main Results:

  • Menopausal hormone therapy failed to prevent clinical cardiovascular events in healthy women and those with coronary heart disease.
  • Hormone therapy increased the risk of coronary heart disease events, myocardial infarction, stroke, and venous thromboembolism.
  • Increased risk of breast cancer was also observed with hormone therapy.

Conclusions:

  • The harms of menopausal hormone therapy likely outweigh the benefits for most women in chronic disease prevention.
  • Proven coronary risk reduction strategies include smoking cessation, healthy diet, physical activity, weight management, and managing hypertension and hypercholesterolemia.

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