Hormone therapy to prevent disease and prolong life in postmenopausal women

Grady, D.; Rubin, S. M.; Petitti, D B; Fox, Carly; Black, Denise; Ettinger, Bruce; Ernster, Virginia L.; Cummings, Steven R.

doi:10.1016/0020-7292(93)90679-q

Cited by 489 publications

(685 citation statements)

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“…[109][110][111] This apparent protective effect was considered by many to be biologically plausible because of the marked differences in coronary heart disease rates between men and women before the menopause, as well as the known effects of oestrogens on lipid profiles. [111][112][113] As a result, hormone replacement therapy was widely prescribed to prevent coronary disease (even though it was not licensed for that purpose), 114 becoming one of the most commonly used medications in industrialized countries.…”

Section: Biases Due To Differences In Underlying Risks Of Health Outcmentioning

confidence: 99%

Interpretation of the evidence for the efficacy and safety of statin therapy

et al. 2016

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms SummaryThis review is intended to help clinicians, patients and the public make informed decisions about statin therapy for the prevention of heart attacks and strokes. It explains how the evidence that is available from randomized controlled trials yields reliable information about both the efficacy and safety of statin therapy. In addition, it discusses how claims that statins commonly cause adverse effects reflect a failure to recognise the limitations of other sources of evidence about the effects of treatment.Large-scale randomized trial evidence shows that statin therapy reduces the risk of heart attacks, ischaemic strokes and coronary revascularization procedures ("major vascular events") by about one quarter for each mmol/L reduction in low density lipoprotein (LDL) cholesterol during each year (after the first) that it continues to be taken. The absolute benefits of statin therapy depend on an individual's absolute risk of occlusive vascular events and the absolute reduction in LDL cholesterol that is achieved. For example, lowering LDL cholesterol by 2 mmol/L (77 mg/dL) with an effective low-cost statin regimen (e.g. atorvastatin 40 mg daily, costing about £2 per

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Section: Biases Due To Differences In Underlying Risks Of Health Outcmentioning

confidence: 99%

Interpretation of the evidence for the efficacy and safety of statin therapy

et al. 2016

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“…Neither Women's Health Initiative trial showed an overall protective effect of hormone therapy for coronary events, 1,2 in contrast to results of earlier observational studies. 3,4 The reasons for this discrepancy are not yet determined but may be related to differences in baseline CHD risks of the study populations and the distributions of risk factors such as lipids and hsCRP. Because clinical trials have demonstrated a small overall increase in the absolute risk of short term hormone therapy use for CHD events in postmenopausal women, we asked whether commonly utilized biomarkers (lipids and hsCRP) could be useful for predicting hormone therapy-mediated CHD risk.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Baseline Lipids and C-Reactive Protein in Women Receiving Menopausal Hormone Therapy as Predictors of Treatment-Related Coronary Events

Bray

Larson

LaCroix

et al. 2008

The American Journal of Cardiology

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“…However, these subjects carry a high risk for future vascular disease events [19,20]. On the basis of epidemiological observations, it was suggested that healthy women at increased cardiovascular risk might benefit most from HRT [21]. For women with manifest CAD, two large randomized intervention trials recently demonstrated that conjugated equine estrogens combined with medroxyprogesterone acetate do not prevent cardiovascular events [22] and do not slow progression of angiographically observed coronary atherosclerosis [6].…”

Section: Discussionmentioning

confidence: 99%

“…For women with manifest CAD, two large randomized intervention trials recently demonstrated that conjugated equine estrogens combined with medroxyprogesterone acetate do not prevent cardiovascular events [22] and do not slow progression of angiographically observed coronary atherosclerosis [6]. The latter finding was independent from the addition of medroxyprogesterone acetate [6], which has been accused of antagonizing the beneficial effect of estrogens [21][22][23]. In response to these new findings, the perspective has shifted to HRT as a means of primary prevention [24].…”

Section: Discussionmentioning

confidence: 99%