Document Detail

An update on menopausal hormone replacement therapy in women and cardiovascular disease.
MedLine Citation:
PMID:  23422240     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: This review presents the available evidence for effects of menopausal hormone replacement therapy (MHT), more specifically estrogen, and selective estrogen receptor modulators on the cardiovascular system with a focus on randomized controlled trials (RCTs) published since 2010.
RECENT FINDINGS: In contrast to early observational studies, the Women's Health Initiative, the largest randomized controlled trial of MHT in generally healthy women, suggested harmful cardiovascular effects. Subsequent subanalyses of the Women's Health Initiative and other studies suggest the cardiovascular effects of MHT may vary by age and time since menopause, giving rise to a 'timing hypothesis'. Recent trials have looked at this issue by evaluating surrogate markers of cardiovascular disease (CVD) or CVD events adjudicated as secondary outcomes in RCTs and show a reduction in events with MHT.
SUMMARY: Athough the data overall do not support the use of MHT or selective estrogen receptor modulator for primary prevention of CVD, evidence is accumulating that careful use of MHT for perimenopausal symptoms may not carry CVD harm. This review highlights some of the strengths and weaknesses of these recent reports. Ongoing studies of MHT will shed more light on the interaction between age or time after menopause and the vascular effects of MHT.
Carolina Valdiviezo; Shari Lawson; Pamela Ouyang
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in endocrinology, diabetes, and obesity     Volume:  20     ISSN:  1752-2978     ISO Abbreviation:  Curr Opin Endocrinol Diabetes Obes     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-02-25     Completed Date:  2013-09-26     Revised Date:  2014-04-10    
Medline Journal Info:
Nlm Unique ID:  101308636     Medline TA:  Curr Opin Endocrinol Diabetes Obes     Country:  England    
Other Details:
Languages:  eng     Pagination:  148-55     Citation Subset:  IM    
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MeSH Terms
Administration, Cutaneous
Administration, Oral
Cardiovascular Diseases / chemically induced,  epidemiology*,  prevention & control
Estrogen Replacement Therapy* / adverse effects
Middle Aged
Pyrrolidines / administration & dosage*,  adverse effects,  pharmacology
Randomized Controlled Trials as Topic
Receptors, Estrogen
Stroke / chemically induced,  epidemiology*,  prevention & control
Tetrahydronaphthalenes / administration & dosage*,  adverse effects,  pharmacology
Time Factors
United States / epidemiology
Venous Thrombosis / chemically induced,  epidemiology*,  prevention & control
Women's Health
Reg. No./Substance:
0/Pyrrolidines; 0/Receptors, Estrogen; 0/Tetrahydronaphthalenes; 0/cis-1R-(4'-pyrrolidinoethoxyphenyl)-2S-phenyl-6-hydroxy-1,2,3,4-tetrahydronaphthalene, tartrate salt

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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