March 10, 2015

expert reaction to review of hormone replacement therapy and cardiovascular disease in women

An update to a review of the evidence around hormone replacement therapy (HRT) and incidence of cardiovascular disease in women has been published in the Cochrane Library. The authors report that there was no overall protective effect of HRT related to cardiovascular disease, but an increase in risk of stroke. However they report a lower risk for coronary heart disease and mortality for a subgroup of women who started treatment less than ten years after the onset of menopause.

Prof. Dame Valerie Beral, Professor of Epidemiology and Director of Cancer Epidemiology Unit, University of Oxford, said:

“This is an independent review of the totality of the available evidence about the effect of HRT on the risk of heart attack, stroke and blood clots in women. The authors’ conclusion that HRT does not protect against heart disease and increases the risk of stroke and blood clots is consistent with advice given over the last decade by drug regulatory bodies in Europe and in North America. In other words, recent claims by some that HRT might reduce the risk of heart attack are unfounded.”

Dr Tim Chico, Reader in Cardiovascular Medicine / consultant cardiologist, University of Sheffield, said:

“This new analysis of previous trials tells us a number of things, particularly that it is a complicated issue. HRT clearly increases the risk of blood clots (deep vein thrombosis or pulmonary embolism) by around twofold. There have been hopes that HRT could reduce the risk of cardiovascular disease, but this analysis suggests any such benefit is confined to women starting HRT less than ten years after menopause, in whom it might even reduce risk of death overall (while still increasing the risk of blood clots).

“As with all medications, there are both benefits and risks to treatment and these need to be weighed up when deciding to start or stop taking them.”

‘Hormone therapy for preventing cardiovascular disease in post-menopausal women’ by Boardman et al. published in the Cochrane Library on Tuesday 10th March. 

All our previous output on this subject can be seen at this weblink: http://www.sciencemediacentre.org/?s=hormone%20replacement%20therapy&cat

Declared interests

Prof. Dame Valerie Beral is on the Board of MHRA, and researches HRT and cancer

No other interests declared