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Published on: August 13, 2019

Menopausal hormone therapy for cardiovascular protection--unfulfilled expectations

Nanette K Wenger1

  • 1Grady Memorial Hospital, Atlanta, GA, USA. nwenger@emory.edu

Journal of Cardiovascular Translational Research
|June 19, 2010
PubMed

Insights

Menopausal hormone therapy does not prevent heart disease in women, according to clinical trials. Focus on managing cardiovascular risk factors instead.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Women's Health

Background:

  • Observational studies suggested cardioprotection from menopausal hormone therapy (MHT).
  • Biologically plausible mechanisms for MHT benefit exist.
  • Previous research indicated potential cardiovascular risks and benefits.

Purpose of the Study:

  • To evaluate the efficacy of menopausal hormone therapy (MHT) for cardiovascular disease (CVD) prevention.
  • To determine if MHT offers primary or secondary cardioprotection in women.
  • To update clinical recommendations regarding MHT use for CVD prevention.

Main Methods:

  • Analysis of randomized clinical trials (RCTs) in healthy women.
  • Review of RCTs in women with established coronary heart disease.
  • Synthesis of evidence regarding MHT's cardiovascular effects.

Main Results:

  • RCTs failed to demonstrate cardiovascular benefit from MHT.
  • Some RCTs indicated potential harm associated with MHT use.
  • In 2009, MHT was not indicated for primary prevention of coronary heart disease or CVD.

Conclusions:

  • Menopausal hormone therapy is not recommended for cardiovascular disease prevention in women.
  • Aggressive management of established cardiovascular risk factors is crucial for women's heart health.
  • Further research is needed on MHT's mechanisms and potential therapeutic windows.

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