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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

Hormone Replacement Therapy and Adverse Outcomes in Women With Atrial Fibrillation: An Analysis From the Atrial Fibrillation Follow-Up Investigation of Rhythm Management Trial Brief Reports
Conclusions— HRT does not independently predict mortality, thromboembolism, or bleeding in a large cohort of women with atrial fibrillation.
Source: Stroke - September 22, 2014 Category: Neurology Authors: Apostolakis, S., Sullivan, R. M., Olshansky, B., Lip, G. Y. H. Tags: Other Treatment Brief Reports Source Type: research

HRT optimization, using transdermal estradiol plus micronized progesterone, a safer HRT.
Abstract ABSTRACT Hormone replacement therapy (HRT) remains the gold standard for treatment of climacteric symptoms in menopausal women; it is relatively safe in healthy subjects for at least 5 years, provided it had been initiated before the age of 60 years and/or within 10 years from menopause. Estrogen probably adds some cardioprotection, that can, however, be obscured by progestogens, especially medroxyprogesterone acetate (MPA). Oral HRT is associated with an increased risk of venous thromboembolism (VTE), gallbladder disease and possibly stroke. The increased occurrence of all these events can be prevented b...
Source: Climacteric - July 19, 2013 Category: Geriatrics Authors: L'hermite M Tags: Climacteric Source Type: research

In recently postmenopausal women, HRT reduced a composite of death, MI, or heart failure at 10 years.
CONCLUSION In recently postmenopausal women, hormone replacement therapy reduced a composite of death, myocardial infarction, or heart failure after 10 years of therapy and an additional 6 years of follow-up.Hormone replacement therapy (HRT) vs no HRT in recently postmenopausal women†OutcomesEvent ratesAfter 10 y of therapyHRTNo HRTRRR (95% CI)NNT (CI)Death, MI, or HF‡3.2%6.5%50% (11 to 72)31 (22 to 144)At 16 yDeath, MI, or HF§6.6%11%37% (4 to 59)26 (17 to 251)†HF = heart failure; MI = myocardial infarction; other abbreviations defined in Glossary. RRR, NNT, and CI calculated from event rates and hazard ratios in ar...
Source: Annals of Internal Medicine - February 19, 2013 Category: Internal Medicine Authors: Cheung AM Tags: Ann Intern Med 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

The Timing Hypothesis and Hormone Replacement Therapy: A Paradigm Shift in the Primary Prevention of Coronary Heart Disease in Women. Part 2: Comparative Risks
A major misperception concerning postmenopausal hormone replacement therapy (HRT) is that the associated risks are large in magnitude and unique to HRT, but over the past 10 years, sufficient data have accumulated so that the magnitude and perspective of risks associated with the primary coronary heart disease prevention therapies of statins, aspirin, and postmenopausal HRT have become more fully defined. Review of randomized controlled trials indicates that the risks of primary prevention therapies and other medications commonly used in women's health are of similar type and magnitude, with the majority of these risks ca...
Source: Journal of the American Geriatrics Society - May 20, 2013 Category: Geriatrics Authors: Howard N. Hodis, Wendy J. Mack Tags: Updates on Aging Source Type: research

Drugs to be offered to women at high risk of breast cancer
The National Institute of Health and Care Excellence (NICE) has today released updated guidelines on the care of women who are at increased risk of breast cancer due to their family history. One of the main changes to the original guidance from 2004 is that NICE now recommends drug treatment with tamoxifen or raloxifene to reduce risk of breast cancer in a specific group of women who are at high risk of breast cancer and have not had the disease. They say that these treatments could help prevent breast cancer in about 488,000 women aged 35 years and older. The updated guideline has also made changes to the recommende...
Source: NHS News Feed - June 25, 2013 Category: Consumer Health News Tags: Cancer Medical practice QA articles Source Type: news

Time trends in pulmonary embolism: A matter of age and gender
Venous thromboembolism (VTE) is the third most common cardiovascular disease . Pulmonary embolism (PE) is potentially lethal and is the most serious manifestation of VTE . Notably, PE is the leading preventable cause of death in hospitalized patients , and is the third most common cardiovascular cause of death after myocardial infarction and stroke in Western world . Risk factors for VTE and PE include old age, surgery, immobilization, trauma, fractures, cancer, pregnancy, puerperium, oral contraceptive pill (OCP) use, and hormone replacement therapy (HRT) . Genetic factors are also important in VTE risk and family history...
Source: Thrombosis Research - June 24, 2013 Category: Hematology Authors: Bengt Zöller Tags: Editorials 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

Still a place for hormone replacement therapy?
Abstract Hormone replacement therapy (HRT) remains the most efficient treatment to alleviate climacteric symptoms. The drastic decline in their prescription following the WHI is not fully justified. Benefits might be more important than harm in women 50-60 years. French way of treatment does not increase the risk in thrombosis nor stroke and breast cancer risk is less important than with other regimen. One of the major benefits of HRT is the decrease in type 2 diabetes with all the treatments including the French ones. The results of the American randomized trials cannot be fully extrapolated to young postmenopa...
Source: Presse Medicale - November 7, 2013 Category: Journals (General) Authors: Gompel A Tags: Presse Med 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

Female sex as a risk factor for thromboembolism and death in patients with incident atrial fibrillation. The prospective Danish Diet, Cancer and Health study.
In conclusion, in a relatively young population of patients with atrial fibrillation, female sex was associated with a lower risk of thromboembolism and death. PMID: 25055988 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - July 24, 2014 Category: Hematology Authors: Overvad TF, Rasmussen LH, Skjøth F, Overvad K, Albertsen IE, Lane DA, Lip GY, Larsen TB Tags: Thromb Haemost Source Type: research

HRT increases ovarian cancer risk by small amount
Conclusion This systematic review and meta-analysis showed that ovarian cancer risk was significantly increased in current HRT users, even in those with less than five years of HRT use (the average was three years). In ex-users, risks decreased the longer ago HRT use had stopped, but risks during the first few years after stopping remained significant. Furthermore, about a decade after stopping, long-duration hormone therapy use (average nine years of HRT use), there still seemed to be a small excess risk. The review has a few limitations, however. The main one is that the review was heavily influenced by just two of t...
Source: NHS News Feed - February 13, 2015 Category: Consumer Health News Tags: Cancer Medication Older people Source Type: news

Multiple Cerebral Infarctions in a Patient with Adenomyosis on Hormone Replacement Therapy: A Case Report
A 59-year-old woman was admitted to our hospital because of repeated episodes of bilateral hand weakness. She had a 10-year history of combined estrogen –progestin therapy for menopausal symptoms. Magnetic resonance imaging on admission showed multiple hyperintense lesions in bilateral cerebral and cerebellar cortices on diffusion-weighted imaging. Transesophageal echocardiography showed thrombus formation on the aortic valve and moderate aortic i nsufficiency. Laboratory test demonstrated elevated CA125 (334.8 U/mL) and D-dimer (7.0 µg/mL) levels.
Source: Journal of Stroke and Cerebrovascular Diseases - August 8, 2016 Category: Neurology Authors: Nanako Hijikata, Yuki Sakamoto, Chikako Nito, Noriko Matsumoto, Arata Abe, Akane Nogami, Takahiro Sato, Hiroyuki Hokama, Seiji Okubo, Kazumi Kimura Tags: Case Studies Source Type: research

Transgender venous thrombosis
A 53-year-old male-to-female transgender patient on cross-sex hormone replacement therapy (CSHT), estradiol 8 mg daily, presented to the emergency department (ED) with acute-onset headache and left visual field disturbances after a recent mechanical fall with head trauma. The medical history was notable for hyperlipidemia. There was no personal or family history of clotting disorders and no history of tobacco use.
Source: Neurology Clinical Practice - December 11, 2017 Category: Neurology Authors: Opaskar, A., Scharf, E. L., Chilungu, M. W., Kelly, A. G. Tags: All Cerebrovascular disease/Stroke, Cerebral venous thrombosis Case Source Type: research

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