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Cardiovascular risk and hormone replacement therapy

Debbie A Lawlor1, George Davey Smith

  • 1Department of Social Medicine, University of Bristol, Bristol, UK. d.a.lawlor@bristol.ac.uk

Current Opinion in Obstetrics & Gynecology
|November 14, 2006
PubMed

Insights

Hormone replacement therapy (HRT) does not protect against coronary heart disease or stroke. Effective cardiovascular disease prevention in women involves managing lifestyle factors like smoking and blood pressure.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Women's Health

Background:

  • Hormone replacement therapy (HRT) is used to manage menopausal symptoms.
  • Its impact on cardiovascular disease (CVD) risk remains a critical area of research.

Purpose of the Study:

  • To review human studies on the relationship between HRT and coronary heart disease (CHD) and stroke.
  • To synthesize evidence from randomized controlled trials (RCTs) regarding HRT's cardiovascular effects.

Main Methods:

  • Analysis of nine secondary prevention RCTs and four primary prevention RCTs.
  • Inclusion of a pooled analysis of 22 RCTs with non-cardiovascular primary aims.
  • Evaluation of evidence on HRT's effect on CHD, stroke, and atherosclerosis progression.

Main Results:

  • Most RCTs indicate HRT either increases CVD risk or has no effect.
  • One small primary prevention RCT suggested a minor protective effect on carotid artery thickness.
  • Overall evidence does not support a protective role for HRT in cardiovascular health.

Conclusions:

  • RCT evidence suggests HRT is not protective against CHD, stroke, or atherosclerosis.
  • Cardiovascular disease prevention in women should prioritize established methods.
  • Effective strategies include managing smoking, obesity, hypertension, dyslipidemia, and glucose intolerance.
Abstract

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