Cardiovascular Disease: Reduced Mortality with Long-Term HRT Treatment

  • Göran Samsioe
Part of the Medical Science Symposia Series book series (MSSS, volume 11)


Several case-control as well as cohort studies indicate that estrogen replacement therapy reduces the risk of arterial disease, especially myocardial infarction. As with all observational studies there are limitations to each study. However, some of the cohort studies are large enough to control for a number of confounding factors. A meta-analysis on estrogen replacement therapy in cardiovascular disease would yield a relative risk of 0.5 [1] in women using estrogen replacement therapy. Data on stroke are less clear. This is at least partly due to the fact that stroke occurs at a relatively more advanced age than myocardial infarction and few women use estrogens beyond 70 [2]. There are also uncertainties about the venous side. Recent data imply that there is a 2–3 fold increase of venous thromboembolism at least during the first year of usage [3-5]. It is also established that estrogen confers protection against osteoporotic fractures and as hip fractures carry a mortality of about 20%, estrogen usage may impact on mortality. Furthermore, long-term use of hormone replacement therapy seems to increase the risk of the diagnosis of breast cancer; the relative risk being 1.3. Most data indicate that prognosis of breast cancers in women on HRT is better than in controls and that mortality in breast cancer may not be increased [6].


Breast Cancer Hormone Replacement Therapy Venous Thromboembolism Estrogen Replacement Therapy Postmenopausal Estrogen 
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  1. 1.
    Stampfer MJ, Colditz GA. Estrogen replacement therapy and coronary heart disease. Preventive Med 1991;20:47–59.CrossRefGoogle Scholar
  2. 2.
    Grodstein F, Stampfer MJ, Manson JE, et al. Postmenopausal estrogen and progestin use and the risk of cardiovascular disease. N Engl J Med 1996;335:453–61.PubMedCrossRefGoogle Scholar
  3. 3.
    Daly E, Vessey MP, Hawkins MM, et al. Risk of venous thromboembolism in users of hormone replacement therapy. The Lancet 1996;348:977–80.CrossRefGoogle Scholar
  4. 4.
    Grodstein F, Stampfer MJ, Goldhaber SZ, et al. Prospective study of exogenous hormones and risk of pulmonary embolism in women. The Lancet 1996;348:983–86.CrossRefGoogle Scholar
  5. 5.
    Jick H, Derby LE, Wald Myers M, et al. Risk of hospital admission for idiopathic venous thromboembolism among users of postmenopausal estrogens. The Lancet 1996;348:981–83.CrossRefGoogle Scholar
  6. 6.
    Birkhäuser M. Hormone replacement therapy and estrogen-dependent cancers. Int J Fertil 1994;39(Suppl 2):99–114.Google Scholar
  7. 7.
    Daly E, Vessey, D, Barlow A, et al. Hormone replacement therapy in a risk-benefit perspective. Maturitas 1996;23:247–59.PubMedCrossRefGoogle Scholar
  8. 8.
    Tieffenberg JA. Socio-economic and quality-of-life analysis in postmenopausal Argentine women. In: Berg G, Hammar M, editors. Modern Management of the Menopause. London: Parthenon Publishing, 1994: 57–70.Google Scholar
  9. 9.
    Office of Technology Assessment, Congress of the United States. Effectiveness and Costs of Osteoporosis. Screening and Hormone Replacement Therapy. US Government Printing Office, August 1995.Google Scholar
  10. 10.
    Wren BG. The effect of oestrogen on the female cardiovascular system. The Medical Journal of Australia 1992;157:204–8.PubMedGoogle Scholar

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© Springer Science+Business Media Dordrecht 1997

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  • Göran Samsioe

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