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HRT review finds increased risk of blood clots and stroke
Conclusion This updated Cochrane review has found that oral HRT increases risk of stroke and blood clots, and does not appear to reduce overall risk of cardiovascular disease or death during follow-up. More exploratory analyses suggested that HRT might reduce risk of death from heart disease or non-fatal heart attack if it was started within 10 years of menopause, but this finding needs further confirmation. The review was carried out using robust methods and the trials were of good quality. Its findings are in line with the previous version of the review, and also with other reviews. There are some points to note: Thi...
Source: NHS News Feed - March 10, 2015 Category: Consumer Health News Tags: Heart/lungs Medication Source Type: news

Study: Different hormone therapy formulations may pose different risks for heart attack and stroke
(Cedars-Sinai Medical Center) Post-menopausal women whose doctors prescribe hormone replacement therapy for severe hot flashes and other menopause symptoms may want to consider taking low doses of FDA-approved bioidentical forms of estrogen or getting their hormones via a transdermal patch. A new observational study shows bioidentical hormones in transdermal patches may be associated with a lower risk of heart attack and FDA-approved products -- not compounded hormones -- may be associated with a slightly lower risk of stroke compared to synthetic hormones in pill form.
Source: EurekAlert! - Medicine and Health - September 18, 2013 Category: Global & Universal Source Type: news

Different risks for heart attack and stroke posed by different hormone therapy formulations
Post-menopausal women whose doctors prescribe hormone replacement therapy for severe hot flashes and other menopause symptoms may want to consider taking low doses of Food and Drug Administration-approved bioidentical forms of estrogen or getting their hormones via a transdermal patch. A new observational study shows bioidentical hormones in transdermal patches may be associated with a lower risk of heart attack and FDA-approved products -- not compounded hormones -- may be associated with a slightly lower risk of stroke compared to synthetic hormones in pill form...
Source: Health News from Medical News Today - September 20, 2013 Category: Consumer Health News Tags: Menopause Source Type: news

Hormone therapy for preventing cardiovascular disease in post-menopausal women.
CONCLUSIONS: Our review findings provide strong evidence that treatment with hormone therapy in post-menopausal women overall, for either primary or secondary prevention of cardiovascular disease events has little if any benefit and causes an increase in the risk of stroke and venous thromboembolic events. PMID: 25754617 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 10, 2015 Category: Journals (General) Authors: Boardman HM, Hartley L, Eisinga A, Main C, Roqué I Figuls M, Bonfill Cosp X, Gabriel Sanchez R, Knight B Tags: Cochrane Database Syst Rev Source Type: research

Cross-sex Hormones and Acute Cardiovascular Events in Transgender Persons: A Cohort Study.
Conclusion: The patterns of increases in VTE and ischemic stroke rates among transfeminine persons are not consistent with those observed in cisgender women. These results may indicate the need for long-term vigilance in identifying vascular side effects of cross-sex estrogen. Primary Funding Source: Patient-Centered Outcomes Research Institute and Eunice Kennedy Shriver National Institute of Child Health and Human Development. PMID: 29987313 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - July 10, 2018 Category: Internal Medicine Authors: Getahun D, Nash R, Flanders WD, Baird TC, Becerra-Culqui TA, Cromwell L, Hunkeler E, Lash TL, Millman A, Quinn VP, Robinson B, Roblin D, Silverberg MJ, Safer J, Slovis J, Tangpricha V, Goodman M Tags: Ann Intern Med Source Type: research

Women's Health Initiative clinical trials: potential interactive effect of calcium and vitamin D supplementation with hormonal therapy on cardiovascular disease
Conclusions: CaD did not consistently modify the effect of CEE therapy or CEE + MPA therapy on CVD events. However, the increased risk of stroke due to CEE therapy appears to be mitigated by CaD supplementation. In contrast, CaD supplementation did not influence the risk of stroke due to CEE + MPA.
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

A Post-Hoc Assessment of Current Hormone Therapy on Revascularization Risk in Women: The Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) (P03.168)
CONCLUSIONS: We found that women on current HRT have lower periprocedural risk associated with CAS or CEA than non-users, but little difference in risk after the procedural period. The mechanism for this unexpected finding is elusive. We urge caution in the interpretation of this post-hoc observation and encourage replication or refutation by other revascularization studies with similar data.Disclosure: Dr. Mackey has nothing to disclose. Dr. Lutsep has received personal compensation for serving on Consultant/Advisory Boards for Concentric Medical/Stryker, Co-Axia, and AGA Medical. Dr. Lutsep has received personal compensa...
Source: Neurology - February 14, 2013 Category: Neurology Authors: Mackey, A., Lutsep, H., Milot, G., Voeks, J., Howard, V., Hughes, S., Tom, M., Longbottom, M., Sheffet, A., Brott, T. Tags: P03 Cerebrovascular Disease III Source Type: research

Hormone Therapy in Women After Heart Transplantation
Conclusions: HT is not associated with poor outcome or adverse effects in female heart transplant patients after age 35 years. However, a larger cohort of patients is necessary to confirm these observations.
Source: Transplantation Proceedings - November 1, 2013 Category: Transplant Surgery Authors: L.C. Kobashigawa, M. Hamilton, M. Rafiei, L. Stern, C.N. Bairey Merz Tags: Thoracic Transplantation Source Type: research

Current recommendations: what is the clinician to do?
Menopausal hormone therapy (HT) has complex biologic effects but continues to have an important clinical role in the management of vasomotor and other menopausal symptoms. The rational use of menopausal HT requires balancing the potential benefits and risks of treatment. Findings from the Women's Health Initiative (WHI) and other randomized clinical trials have helped to clarify the benefits and risks of HT and have provided insights to improve decision making. Several clinical characteristics have utility in identifying women for whom benefits of HT are likely to outweigh the risks. Age and time since menopause are strong...
Source: Fertility and Sterility - March 31, 2014 Category: Reproduction Medicine Authors: JoAnn E. Manson Tags: Views and reviews Source Type: research

Prevention of Cardiovascular Disease in Women
Semin Reprod Med 2014; 32: 447-453DOI: 10.1055/s-0034-1384628Cardiovascular disease is the leading cause of death among women. In fact, the cardiovascular disease mortality rate among women exceeds the rate in men. Unfortunately, many minority women are still unaware of the importance of this disease. All women, including those with no history of cardiovascular disease, should have an accurate estimate of the probability of a cardiovascular disease event (death, myocardial infarction, or stroke) usually within the next decade. Such an estimate will help determine if women are candidates for preventive measures and specific...
Source: Seminars in Reproductive Medicine - October 16, 2014 Category: Reproduction Medicine Authors: Bavry, Anthony A.Limacher, Marian C. Source Type: research

Can HRT in early menopause cut heart disease risk?
ConclusionThis double-blind RCT found that women taking HRT less than six years after the menopause had slower artery wall thickening than those taking a placebo. This represented the main measure of atherosclerosis progression tested; other measures showed no difference, so the results were not as conclusive as they could have been. Women taking HRT 10 or more years after menopause also showed no difference in atherosclerosis progression compared with a placebo, further complicating the picture.An important limitation of this study is the lack of a patient relevant endpoint, such as cardiovascular events or mortality. Pre...
Source: NHS News Feed - April 1, 2016 Category: Consumer Health News Tags: Heart/lungs Medication Source Type: news

Aromatase Inhibitors and the Risk of Cardiovascular Outcomes in Women With Breast Cancer: A Population-Based Cohort Study.
CONCLUSIONS: In this population-based study, aromatase inhibitors were associated with increased risks of heart failure and cardiovascular mortality compared with tamoxifen. There were also trends toward increased risks, although nonsignificant, of myocardial infarction and ischemic stroke. The increased risk of cardiovascular events associated with aromatase inhibitors should be balanced with their favorable clinical benefits compared with tamoxifen. PMID: 32065766 [PubMed - in process]
Source: Circulation - February 17, 2020 Category: Cardiology Authors: Khosrow-Khavar F, Filion KB, Bouganim N, Suissa S, Azoulay L Tags: Circulation Source Type: research

Close monitoring for heart risk needed if breast, prostate cancer treatment includes hormones
(American Heart Association) Patients with breast and prostate cancers who are treated with hormonal therapies have an increased risk of heart attack and/or stroke as they age.The increased likelihood of a heart attack or stroke is greater in patients who already have two or more cardiovascular risk factors such as high blood pressure, high cholesterol, obesity, smoking or a family history of heart disease or stroke.The longer the duration of hormonal therapy, the higher the risk of cardiovascular disease.
Source: EurekAlert! - Medicine and Health - April 26, 2021 Category: International Medicine & Public Health Source Type: news

In assessing risk of hormone therapy for menopause, dose — not form — matters
FINDINGSWhen it comes to assessing the risk of estrogen therapy for menopause, how the therapy is delivered — taking a pill versus wearing a patch on one’s skin — doesn’t affect risk or benefit, researchers at UCLA and elsewhere have found. But with the commonly used conjugated equine estrogen, plus progestogen, the dosage does. Higher doses, especially over time, are associated with greater risk of problems, including heart disease and some types of cancer, especially among obese women.BACKGROUNDThe Women ’s Health Initiative established the potential of estrogen therapy to increase or decrease the risk of strok...
Source: UCLA Newsroom: Health Sciences - July 27, 2017 Category: Universities & Medical Training Source Type: news

Sex steroids and cardiovascular outcomes in transgender individuals: a systematic review and meta-analysis.
Conclusions: Low quality evidence suggests that sex steroid therapy may increase LDL-C and TG and decrease HDL-C levels in FTM, while oral estrogens may increase TGs in MTF. Data about patient important outcomes remain sparse. PMID: 28945852 [PubMed - as supplied by publisher]
Source: The Journal of Clinical Endocrinology and Metabolism - September 13, 2017 Category: Endocrinology Authors: Maraka S, Singh Ospina N, Rodriguez-Gutierrez R, Davidge-Pitts CJ, Nippoldt TB, Prokop LJ, Murad MH Tags: J Clin Endocrinol Metab Source Type: research

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