The impact of hormone replacement therapy (HRT) on cardiovascular (CV) risk is unclear. Observational studies have shown a possible protective effect whereas randomised controlled trials (RCTs) have been mixed.
The latest analysis, undertaken by the Cochrane Collaboration (online, 10 March 2015)
, suggests that HRT has little if any benefit in the primary or secondary prevention of CV disease and causes an increase in the risk of stroke and venous thromboembolic events (VTE).
The review included 19 RCTs, of generally high quality, involving 40,410 postmenopausal women. The relative risks associated with HRT use versus non-use were 1.24 for stroke, 1.92 for any VTE and 1.81 for pulmonary embolism.
“We are confident that the results of our review are close to the true effects,” the authors note.