[CG] HRT and cardiovascular disease
exp date isn't null, but text field is
|Please report any inaccuracies or issues with this guideline using our online form|
Cardiovascular disease is common; therefore we will inevitably see women with cardiovascular disease who wish to use hormone replacement therapy (HRT).
Until the late 1990s oestrogen was thought to protect against coronary heart disease (CHD). However, an RCT, the Women’s Health Initiative (WHI) found an early, transient increase in coronary events in the combined HRT (oestrogen plus progestogen) arm. However, the average age of participants in WHI was 63 years old, and more recent subgroup analyses of data from the WHI trials have questioned these results. HRT use was stratified by age and time since menopause, and this analysis demonstrated more favourable results for all-cause mortality and myocardial infarction in women aged 50-59, and those starting HRT close to menopause (1). The Danish Osteoporosis Prevention Study (DOPS) (2), an open label RCT, showed that HRT was associated with a reduction in cardiovascular disease in women of the same age group.
The NICE Guideline on Menopause (NG23) provides guidance on the use of HRT and the risk of cardiovascular risk, and this is summarized below.
Use the button below to access this resource item.Access this resource