Postmenopausal hormone replacement therapy for the primary prevention of cardiovascular and cerebrovascular disease: systematic review and recommendations
Abramson B L, with The Canadian Task Force on Preventive Health Care
Record ID 32004000229
English
Authors' objectives:
To systematically review the current evidence and make recommendations for the use of hormone replacement therapy (HRT) for primary prevention of cardiovascular and cerebrovascular disease.
Authors' recommendations:
Four out of every ten female deaths in Canada each year are due to heart disease and stroke. Until recently, the role of HRT for primary prevention of both cardio and cerebrovascular disease was not clear, with variable levels of evidence available. Prior to July 2002, seventeen studies meeting inclusion criteria were published, one small RCT and 16 prospective cohort studies. Most showed a protective association with estrogen, alone or in combination with a progestin, on myocardial infarction or death from cardiovascular disease in peri-menopausal women without established CAD. This is in contrast to the recent Womens Health Initiative trial, which showed evidence of potential harm. There is no beneficial effect from HRT on rates of stroke or stroke related death in the available studies. HRT for the sole purpose of prevention of cardiac disease is therefore not indicated.
There is fair evidence to recommend against the use of HRT for the primary prevention of myocardial infarction and death from cardiovascular disease in peri-menopausal women without established CAD (D recommendation). To maintain good heart health, women should be advised to adopt other effective preventive strategies, such as lifestyle changes that include increased exercise, lower fat diets, smoking cessation, and blood pressure assessment and control. There is insufficient evidence to make a recommendation on the use of HRT for the primary prevention of stroke and death from cerebrovascular disease.
Authors' methods:
Systematic review
Details
Project Status:
Completed
URL for project:
http://www.ctfphc.org/Full_Text/CTF_HRTCVD_TR_final.pdf
Year Published:
2003
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Canada
MeSH Terms
- Female
- Hormone Replacement Therapy
- Women's Health
- Cardiovascular Diseases
- Cerebrovascular Disorders
Contact
Organisation Name:
Canadian Task Force on Preventive Health Care
Contact Address:
Canadian Task Force on Preventive Health Care, 100 Collip Circle, Suite 117, London, ON, N6G 4X8, Canada. Tel: 519-858-5181; Fax: 519-858-5112
Contact Name:
ctf@ctfphc.org
Contact Email:
ctf@ctfphc.org
Copyright:
Canadian Task Force on Preventive Health Care (CTFPHC)
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