Key result
Hormone replacement therapy did not reduce mortality (1.9% vs 1.9%; OR 1.05, 95% CI 0.86-1.30, p=0.58), myocardial infarction, or revascularization compared with control.
Why the study?
Does hormone replacement therapy reduce cardiovascular events in women?
Meta-Analysis (n=21,066)
Does hormone replacement therapy reduce cardiovascular events in women?
Odds Ratio: 1.05 (95% CI 0.86–1.3)
Absolute Event Rate: 1.9% vs 1.9%
p-value: p=0.58
Hormone replacement therapy is not an effective secondary cardiovascular preventive measure as it does not reduce death, myocardial infarction, or revascularization rates.
No CV benefit from HRT in women; confirms prior RCTs and supports avoiding its use for prevention.
BACKGROUND: Coronary artery disease is the leading cause of death in women. Several randomized clinical trials of hormone replacement therapy (HRT) in women with and without coronary artery disease have found no benefit of HRT in decreasing cardiovascular events. The purpose of this study was to assess the benefits and risks of HRT for prevention of cardiovascular events by conducting a meta-analysis of all randomized trials of HRT, and estimate cardiovascular event rates. METHODS AND RESULTS: All relevant randomized, clinical trials were identified in MEDLINE (1966-2001), HealthSTAR (1975-2001), and Cochrane Library databases. The search terms were hormone replacement or HRT, estrogen, progesterone, women and heart disease. We used all published data of randomized, clinical trials of HRT if they reported cardiovascular endpoints. Meta-analysis of the randomized, clinical trials involving 21,066 patients revealed that HRT did not reduce mortality compared with control group (1.9 vs. 1.9%, odds ratio 1.05, 95% CI 0.86-1.30, p = 0.58) or significantly reduce risk of myocardial infarction (3.7 vs. 3.7%, odds ratio 1.04, 95% CI 0.90-1.21, p = 0.58) or revascularization (6.4 vs. 6.8%, odds ratio 0.95, 95% CI 0.85-1.08, p = 0.50). The rate of acute coronary syndrome rate was 9.1% in the HRT group vs. 9.3% with odds ratio 1.00, 95% CI 0.90-1.12, p = 0.98. CONCLUSION: HRT use is not associated with reduced death, myocardial infarction or revascularization rate. This suggests that HRT is not an effective secondary cardiovascular preventive measure.
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Cho et al. (2005) conducted a meta-analysis in Coronary artery disease (n=21,066). Hormone replacement therapy (HRT) vs. control group was evaluated on mortality (OR 1.05, 95% CI 0.86-1.30, p=0.58). Hormone replacement therapy did not reduce mortality (1.9% vs 1.9%; OR 1.05, 95% CI 0.86-1.30, p=0.58), myocardial infarction, or revascularization compared with control.
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