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Menopausal hormone therapy and risk of cardiovascular events in women with prediabetes or type 2 diabetes: A pooled analysis of 2917 postmenopausal women
CONCLUSIONS: MHT is associated with statistically reduced CVD risk among white but not black women with PreDM or DM. Race is an effect modifier in the association between MHT use and CVD.PMID:35114556 | DOI:10.1016/j.atherosclerosis.2022.01.016
Source: Atherosclerosis - February 3, 2022 Category: Cardiology Authors: Yilin Yoshida Zhipeng Chen Robin L Baudier Marie Krousel-Wood Amanda H Anderson Vivian A Fonseca Franck Mauvais-Jarvis Source Type: research

Randomized Trial Evaluation of Benefits and Risks of Menopausal Hormone Therapy Among Women Aged 50-59.
Abstract The health benefits and risks of menopausal hormone therapy among women aged 50-59 years are examined in the Women's Health Initiative randomized, placebo-controlled trials using long-term follow-up data and a parsimonious statistical model that leverages data from older participants to increase precision. These trials enrolled 27,347 healthy post-menopausal women aged 50-79 at 40 U.S. clinical centers during 1993-1998, including 10,739 post-hysterectomy participants in a trial of conjugated equine estrogens, and 16,608 participants with uterus in the trial of these estrogens plus medroxyprogesterone acet...
Source: Am J Epidemiol - October 7, 2020 Category: Epidemiology Authors: Prentice RL, Aragaki AK, Chlebowski RT, Rossouw JE, Anderson GL, Stefanick ML, Wactawski-Wende J, Kuller LH, Wallace R, Johnson KC, Shadyab AH, Gass M, Manson JAE Tags: Am J Epidemiol Source Type: research

The Women's Health Initiative Estrogen-alone Trial had differential disease and medical expenditure consequences across age groups
Conclusion: The decline in ET utilization had differential disease and expenditure consequences by age groups in the United States. These results are limited by the lack of inclusion of vasomotor symptom benefit and costs of alternative medications for these symptoms in the analysis.
Source: Menopause - May 29, 2020 Category: OBGYN Tags: Original Studies Source Type: research

Cardiovascular Risk/Benefit Profile of MHT.
Conclusion: CV risk calculation should be considered by clinicians in order to exclude patients with high CV risk, in whom MHT is contraindicated. Assessing risks and benefits in a patient-centered approach according to individual's features, health status, and personal preferences is important in order to realize a safe and effective treatment. PMID: 31500138 [PubMed - in process]
Source: Medicina (Kaunas) - September 5, 2019 Category: Universities & Medical Training Authors: Villa P, Amar ID, Shachor M, Cipolla C, Ingravalle F, Scambia G Tags: Medicina (Kaunas) 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

Cardiovascular Programming During and After Diabetic Pregnancy: Role of Placental Dysfunction and IUGR
This study demonstrated that the incidence of ischemic heart disease and death were three times higher among men with low birth weight compared to men with high birth weight (5). Epidemiological investigations of adults born at the time of the Dutch famine between 1944 and 1945 revealed an association between maternal starvation and a low infant birth weight with a high incidence of hypertension and coronary heart disease in these adults (23). Furthermore, Painter et al. reported the incidence of early onset coronary heart disease among persons conceived during the Dutch famine (24). In that regard, Barker's findin...
Source: Frontiers in Endocrinology - April 8, 2019 Category: Endocrinology Source Type: research

The 2017 hormone therapy position statement of The North American Menopause Society
The 2017 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) updates the 2012 Hormone Therapy Position Statement of The North American Menopause Society and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2012 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence. The Panel's recommendations were reviewed and approved by...
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

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

The 2017 hormone therapy position statement of The North American Menopause Society
Abstract: The 2017 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) updates the 2012 Hormone Therapy Position Statement of The North American Menopause Society and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2012 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence. The Panel's recommendations were reviewed and a...
Source: Menopause - June 27, 2017 Category: OBGYN Tags: Position Statement Source Type: research

Anti-M üllerian Hormone Trajectories Are Associated With Cardiovascular Disease in Women: Results From the Doetinchem Cohort Study.
CONCLUSIONS: These results indicate that AMH trajectories in women are independently associated with CVD risk. Therefore, we postulate that the decline of circulating AMH levels may be part of the pathophysiology of the increased cardiovascular risk of earlier menopause. Confirmation of this association and elucidation of its underlying mechanisms are needed to place these results in a clinical perspective. PMID: 28153992 [PubMed - in process]
Source: Circulation - February 6, 2017 Category: Cardiology Authors: de Kat AC, Verschuren WM, Eijkemans MJ, Broekmans FJ, van der Schouw YT Tags: Circulation Source Type: research

The evolving role of oral hormonal therapies and review of conjugated estrogens/bazedoxifene for the management of menopausal symptoms.
Authors: Parish SJ, Gillespie JA Abstract This review describes the evolving role of oral hormone therapy (HT) for treating menopausal symptoms and preventing osteoporosis, focusing on conjugated estrogens/bazedoxifene (CE/BZA). Estrogens alleviate hot flushes and prevent bone loss associated with menopause. In nonhysterectomized women, a progestin should be added to estrogens to reduce the risk of endometrial cancer. Use of HT declined since the Women's Health Initiative (WHI) studies showed that HT does not prevent coronary heart disease (CHD) and that conjugated estrogens/medroxyprogesterone acetate increased th...
Source: Postgraduate Medicine - February 1, 2017 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Withdrawal of hormone therapy and increased risk of cardiovascular disease.
Abstract Many menopause specialists follow the principle of prescribing postmenopausal hormone therapy (HT) for the shortest duration needed, in order to decrease the risk of some related serious adverse effects, such as breast cancer. Based on several large studies, it seems, however, that withdrawal of HT may be associated with immediate, though small increased risk of coronary heart disease and stroke. Cessation of HT correlates with increased risk of fractures as well. This information should be relayed to hormone users while discussing the continuation of HT with their health-care provider, but, since the pot...
Source: Climacteric - April 13, 2016 Category: Geriatrics Authors: Pines A Tags: Climacteric Source Type: research

Vaginal estradiol use and the risk for cardiovascular mortality
STUDY QUESTION Does the use of post-menopausal vaginal estradiol (VE) affect the mortality risk for coronary heart disease (CHD) and stroke. SUMMARY ANSWER The use of VE reduces the risk for cardiovascular mortality. WHAT IS KNOWN ALREADY A growing number of women use VE for post-menopausal genitourinary symptoms. Although this therapy is intended to have only local effects, estrogen is absorbed into the blood circulation and thus VE use may also have systemic effects. STUDY DESIGN, SIZE, DURATION We studied a nationwide cohort in Finland 1994–2009 during which post-menopausal women (n = 195 756) initiated the use...
Source: Human Reproduction - March 15, 2016 Category: Reproduction Medicine Authors: Mikkola, T. S., Tuomikoski, P., Lyytinen, H., Korhonen, P., Hoti, F., Vattulainen, P., Gissler, M., Ylikorkala, O. Tags: Puberty, Aging and HRT Source Type: research

Cochrane corner: oral hormone therapy and cardiovascular outcomes in post-menopausal women
Introduction Hormone therapy (HT) is commonly prescribed for the relief of climacteric symptoms in post-menopausal women; 54% (620490) of women enrolled in the Million Women Study1 in the UK (mean age 56 years) have tried it and 31% (358252) use it. Observational studies have shown oral HT is associated with lower rates of cardiovascular disease in post-menopausal women2; however randomised controlled trials (RCTs) have presented mixed results. The 2002 publication of the Women's Health Initiative I (WHI I) reported an association between combined oestrogen and progestin use and increased rates of both coronary heart...
Source: Heart - December 11, 2015 Category: Cardiology Authors: Boardman, H., Hartley, L., Eisinga, A., Main, C., Figuls, M. R. I. Tags: Drugs: cardiovascular system, Cochrane Corner, Acute coronary syndromes, Venous thromboembolism, Epidemiology Editorials Source Type: research

Women's Health Initiative estrogen plus progestin clinical trial: a study that does not allow establishing relevant clinical risks
Conclusions: The differences in RMST for the outcomes of the WHI study are too small to establish clinical risks related to hormone therapy use.
Source: Menopause - December 1, 2015 Category: OBGYN Tags: Original Articles Source Type: research

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