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Updated: May 11, 2026

An In Vivo Estrogen Deficiency Mouse Model for Screening Exogenous Estrogen Treatments of Cardiovascular Dysfunction After Menopause
06:18

An In Vivo Estrogen Deficiency Mouse Model for Screening Exogenous Estrogen Treatments of Cardiovascular Dysfunction After Menopause

Published on: August 13, 2019

Effect of hormone replacement therapy on cardiovascular outcomes: a meta-analysis of randomized controlled trials

Dicheng Yang1, Jing Li, Zhongxiang Yuan

  • 1Department of Cardiovascular Surgery, Shanghai First People's Hospital affiliated to Shanghai Jiao Tong University, Shanghai, China.

Plos One
|May 14, 2013
PubMed

Insights

Hormone replacement therapy (HRT) does not impact coronary events or mortality. However, HRT may increase the risk of stroke in postmenopausal women, highlighting a critical cardiovascular consideration.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Women's Health

Background:

  • Hormone replacement therapy (HRT) is utilized for menopausal symptom management and potential cardiovascular event prevention.
  • The cardiovascular benefits and risks associated with HRT remain a subject of ongoing debate and research.

Purpose of the Study:

  • To systematically evaluate the impact of HRT on various cardiovascular outcomes in postmenopausal women.
  • To synthesize evidence from multiple clinical trials to provide a comprehensive risk-benefit analysis of HRT concerning cardiovascular health.

Main Methods:

  • A systematic literature search was conducted across PubMed, EmBase, and Cochrane Central Register of Controlled Trials.
  • A random-effects meta-analysis was performed on data from 10 eligible trials involving 38,908 postmenopausal women.
  • Relative risks were calculated from raw data to estimate the effects of HRT on clinical outcomes.

Main Results:

  • Estrogen combined with medroxyprogesterone acetate showed no significant effect on coronary events, myocardial infarction, cardiac death, total death, or revascularization compared to placebo.
  • Estrogen therapy alone did not significantly affect coronary events, myocardial infarction, cardiac death, total mortality, or revascularization.
  • Estrogen therapy alone was associated with a statistically significant 27% increased risk of incident stroke (RR, 1.27; 95%CI: 1.06-1.53; P=0.01).

Conclusions:

  • HRT, in the forms studied, does not appear to influence the incidence of major coronary events, myocardial infarction, cardiac death, or overall mortality.
  • Estrogen therapy, particularly when used alone, may be associated with an elevated risk of incident stroke in postmenopausal women.
  • The findings underscore the importance of considering the specific type of HRT and individual risk factors when managing menopausal symptoms and cardiovascular health.
Abstract

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