Is postmenopausal hormone replacement therapy suitable after a cardio- or cerebrovascular event?

Windler, Eberhard; Stute, Petra; Ortmann, Olaf; Mueck, Alfred O (2015). Is postmenopausal hormone replacement therapy suitable after a cardio- or cerebrovascular event? Archives of gynecology and obstetrics, 291(1), pp. 213-217. Springer 10.1007/s00404-014-3485-0

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PURPOSE Vascular disease is the leading cause of death in women. One-third of acute events affect women below age 60, when the prevalence of menopausal symptoms is high. This raises the question if hormone replacement therapy (HRT) may be an appropriate treatment for individual women although vascular disease is generally considered a contraindication. METHODS Selective literature search was used for this study. RESULTS In healthy women, HRT increases risks for venous thromboembolism and ischemic stroke, but for cardiovascular disease apparently only beyond 10 years after menopause or 60 years of age. Limited data in women with cardio or cerebrovascular disease have not demonstrated an increased risk for a vascular recurrent event, but for the first year after initiation. In HRT users affected by a cardiovascular event continuation of HRT has not been found to be associated with adverse outcome. Low dose estradiol--preferentially as transdermal patches, if necessary combined with metabolically neutral progestins--appears to convey lower risk. CONCLUSIONS Safety data on HRT in survivors of cardiovascular events or ischemic stroke are limited, but exceptionally increased risk appears to be excluded. If off-label use of HRT is considered to be initiated or continued in women with cardio- or cerebrovascular disease, extensive counseling on the pros and cons of HRT is mandatory.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Stute, Petra

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0932-0067

Publisher:

Springer

Language:

English

Submitter:

Nathalie Ursula Becher

Date Deposited:

21 May 2015 14:32

Last Modified:

11 Nov 2015 09:22

Publisher DOI:

10.1007/s00404-014-3485-0

PubMed ID:

25322975

BORIS DOI:

10.7892/boris.68931

URI:

https://boris.unibe.ch/id/eprint/68931

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