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Whether the use of unopposed oestrogen following a myocardial infarction is beneficial or harmful remains unclear, and in individual women the effects may vary according to the underlying risk profile
Commentary on: Cherry N, McNamee R, Heagerty A, et al.. Long-term safety of unopposed oestrogen used by women surviving myocardial infarction: a 14-year follow-up of the ESPRIT randomised controlled trial. BJOG 2014;121:700–5; discussion 705. Context There is a biological and epidemiological evidence to suggest that high oestrogen levels retard the progression of atherogenesis, reducing the risk of myocardial infarction. Whether such an effect is evident following a first myocardial infarction is unclear. A randomised controlled trial was carried out to investigate. Following completion of the trial the authors conti...
Source: Evidence-Based Medicine - September 15, 2014 Category: Internal Medicine Authors: Shapiro, S. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Contraception, Drugs: obstetrics and gynaecology, Ischaemic heart disease, Vulvovaginal disorders Harm Source Type: research

Cardiovascular benefits of HRT may differ by patient age
Commentary on: Main C, Knight B, Moxham T, et al.. Hormone therapy for preventing cardiovascular disease in post-menopausal women. Cochrane Database Syst Rev 2013;(4):CD002229. Context In early postmenopausal women oestrogen and/or hormone replacement therapy (ERT/HRT) are used to alleviate symptoms and reduce the probability of diseases related to ovarian hormones deprivation. However, in late postmenopausal women the initiation of HRT has a negative risk/benefit balance mainly because of the increased risk of cardiovascular diseases (CVD). Methods Main et al performed a meta-analysis of randomised controlled trials (RCTs...
Source: Evidence-Based Medicine - March 19, 2014 Category: Internal Medicine Authors: Rosano, G., Vitale, C. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Contraception, Drugs: obstetrics and gynaecology, Menopause (including HRT), Interventional cardiology, Ischaemic heart disease, Venous thromboembolism, Radiology Source Type: research

While hormone therapy unlikely harmful in younger postmenopausal women at low CV risk, protective effects cannot be claimed
Commentary on: Schierbeck LL, Rejnmark L, Tofteng CL, et al.. Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial. BMJ 2012;345:e6409. Context The last 10 years have clarified the issues regarding postmenopausal hormone therapy (HT) and cardiovascular disease (CVD). Prior to the large, randomised women's health initiative (WHI),1 observational studies had suggested a protective cardiovascular (CV) effect. The WHI showed no benefit, and increased thromboembolic and CV events in women taking HT. The WHI findings have been challenged because of the older age of the...
Source: Evidence-Based Medicine - September 19, 2013 Category: Internal Medicine Authors: Abramson, B. L. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Menopause (including HRT), Ischaemic heart disease, Venous thromboembolism Therapeutics Source Type: research

Hormone therapy not recommended for chronic disease prevention in menopausal women
Commentary on: Nelson HD, Walker M, Zakher B, et al.. Menopausal hormone therapy for the primary prevention of chronic conditions: a systematic review to update the US Preventive Services Task Force recommendations. Ann Intern Med 2012;157:104–13. Context In 2005, the US Preventive Services Task Force (USPSTF) updated its 2002 hormone replacement therapy recommendations, advising against the routine use of oestrogen and progestin (E+P) and unopposed oestrogen (E) to prevent chronic conditions in menopausal women. Menopausal hormone therapy (MHT) had been commonly prescribed to prevent conditions such as cardiovascula...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Wenger, N. K. Tags: Pancreas and biliary tract, Epidemiologic studies, Drugs: cardiovascular system, Dementia, Stroke, Contraception, Drugs: obstetrics and gynaecology, Menopause (including HRT), Ischaemic heart disease, Venous thromboembolism, Memory disorders (psychiatry), Source Type: research