According to evidence provided by a Cochrane Library review, hormone replacement therapy does not safeguard post-menopausal women against cardiovascular disease. Conversely, the treatment can increase the risk of stroke.
Hormone Replacement Therapy (HRT) is used to control the symptoms of menopause and prevent cardiovascular disease in women in the post-menopausal period. The new evidence now provided assessed the outcomes of HRT for a minimum length of time of six months in more than 40,000 women worldwide.
During the trials, women underwent treatment from seven months to 10 years. The results revealed that healthy women or women with pre-existing heart disease treatment with HRT is not protective against death of any cause, and particularly of death from non-fatal heart attacks or angina.
The new evidence now provided assessed the outcomes of HRT for a minimum length of time of six months in more than 40,000 women worldwide. However, in this group of women the authors found an increased risk of deep vein thrombosis (DVT).
Dr. Henry Boardman from the Department of Cardiovascular Medicine at the University of Oxford said that the time and age women started their HRT is a major factor to be considered when weighing the risks and benefits of the treatment.
He said in a recent news release, “The evidence we have provides some support for the so-called ‘Timing Hypothesis’, but we should bear in mind the size of this effect. When we looked at the results according to the age of women, or by how long since their menopause that they started treatment, we found that if 1000 women under 60 years old started hormone therapy we would expect six fewer deaths, eight fewer cases of heart disease and five extra blood clots over about seven years, compared to a 1000 similar women who did not start hormone therapy.”
Dr. Boardman continued that “the findings of this Cochrane review need to be carefully considered. This is a complicated health issue, where the same treatment offers benefits in some women, but harms in others.”
Dr David Tovey, Editor in Chief of the Cochrane Library commented in the news release, “This review adds a few more pieces to a complicated jigsaw of evidence relating to the use of HRT to treat symptoms of the menopause. The main analysis that the authors did, found no benefit and so we need to apply caution to the results from the subgroup analysis. However if true, this apparent benefit in preventing heart disease in younger women should be considered alongside other possible benefits and emerging evidence of harms, including the risk of breast cancer, ovarian cancer, and DVT.”
The Cochrane Review’s author, Dr. Henry Boardman, concludes in the news release, “Hormone therapy remains a valid treatment option for women who are significantly troubled by menopausal symptoms, however the risks and benefits of such treatment vary according to age and medical history. Discussion with your GP is recommended when considering treatment.”
