Association between hormone replacement therapy and subsequent arterial and venous vascular events: a meta-analysis
View abstract on PubMed
Summary
This summary is machine-generated.Hormone replacement therapy (HRT) increases the risk of stroke and venous thromboembolism (VTE), but not coronary heart disease (CHD). Combined HRT, particularly with progesterone, elevates VTE risk more than estrogen alone.
Area Of Science
- Cardiovascular Medicine
- Endocrinology
- Public Health
Background
- Randomized controlled trials (RCTs) have indicated potential risks associated with hormone replacement therapy (HRT).
- The impact of HRT on coronary heart disease (CHD) has remained uncertain despite existing evidence on other cardiovascular events.
Purpose Of The Study
- To systematically analyze the risks of stroke, venous thromboembolism (VTE), and coronary heart disease (CHD) associated with HRT.
- To evaluate the influence of HRT type (combined vs. estrogen-only) and patient age on these cardiovascular risks.
Main Methods
- A meta-analysis of 31 RCTs involving 44,113 subjects was conducted.
- Event rates for stroke, transient ischemic attack (TIA), CHD (myocardial infarction, unstable angina, sudden cardiac death), and VTE (pulmonary embolism, deep vein thrombosis) were analyzed.
- Sensitivity analyses were performed based on HRT type and subject age.
Main Results
- HRT was significantly associated with an increased risk of stroke (OR 1.32, 95% CI 1.14-1.53) and VTE (OR 2.05, 95% CI 1.44-2.92).
- No significant increase in CHD events was observed (OR 1.02, 95% CI 0.90-1.11).
- Combined HRT (estrogen with progesterone) doubled the risk of VTE compared to estrogen monotherapy, and increased stroke severity.
Conclusions
- HRT use is linked to a higher risk of stroke and VTE, but not CHD.
- The increased risk associated with HRT was not significantly influenced by patient age in the studied trials.
- Combined HRT poses a greater VTE risk than estrogen monotherapy, highlighting the importance of HRT formulation in cardiovascular safety.