This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages without signing in

HRT and heart disease

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

NICE state with respect to HRT and cardiovascular disease (1):

  • HRT:
    • does not increase cardiovascular disease risk when started in women aged under 60 years
    • does not affect the risk of dying from cardiovascular disease

  • the presence of cardiovascular risk factors is not a contraindication to HRT as long as they are optimally managed

  • the baseline risk of coronary heart disease and stroke for women around menopausal age varies from one woman to another according to the presence of cardiovascular risk factors

  • HRT with oestrogen alone is associated with no, or reduced, risk of coronary heart disease

  • HRT with oestrogen and progestogen is associated with little or no increase in the risk of coronary heart disease.

Data shows taking oral (but not transdermal) oestrogen is associated with a small increase in the risk of stroke. Also explain that the baseline population risk of stroke in women aged under 60 years is very low

Current HRT users

Treatment duration <5 years

Treatment duration 5-10 years

>5 years since stopping treatment

Women on oestrogen alone

RCT estimate

6 fewer (-10 to 1)

No available data

No available data

6 fewer (-9 to -2)

Women on oestrogen alone

Observational estimate

6 fewer (-9 to -3)

No available data

No available data

No available data

Women on oestrogen + progestogen

RCT estimate

5 more (-3 to 18)

No available data

No available data

4 more (-1 to 11)

Women on oestrogen + progestogen

Observational estimate

No available data

No available data

No available data

No available data

A joint societies statement has noted with repect to HRT and cardiovascular disease (2):

Key points summary

- The timing MHT (menopausal hormone therapy) is initiated, referred to as the ‘timing hypothesis’ and ‘the cardiovascular window of opportunity’, can have a significant impact on the risk of CVD with MHT intake

- Cochrane data-analysis shows that MHT initiated within 10 years of the menopause is likely to be associated with a reduction in coronary heart disease and cardiovascular mortality.

- Evidence from the Cochrane data-analysis and that from the long-term follow-up data of the WHI showed no increase in cardiovascular events, cardiovascular mortality or all-cause mortality in women who initiated MHT more than 10 years after the menopause

 

Reference:


Related pages

Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.