A prospective observational study of postmenopausal hormone therapy and primary prevention of cardiovascular disease

Grodstein, Fran; Manson, JE; Colditz, Graham A.

doi:10.1016/s1062-1458(01)00239-2

Cited by 142 publications

(196 citation statements)

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“…48,49 However, large-scale, placebocontrolled, randomized trials, such as the HERS 6 and the WHI, 7 did not confirm the findings of the observational studies. In the WHI, HRT with conjugated equine estrogen plus medroxyprogesterone acetate increased the incidence of CVD instead, particularly in women older than 60 years of age, although women who started HRT soon after menopause tended to have a decreased risk for coronary heart disease.…”

Section: Hrt and Cvdmentioning

confidence: 99%

Hormonal effects on blood vessels

Akishita

2012

Hypertens Res

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The incidence of cardiovascular disease (CVD) is lower in younger women than in men of the same age, but it increases after menopause, implicating the atheroprotective action of endogenous estrogen. Although observational studies have suggested the efficacy of estrogen therapy in postmenopausal women, placebo-controlled, randomized trials, such as the Women's Health Initiative, have not confirmed effects of estrogen therapy on CVD. Conversely, basic, experimental research has progressed and provided mechanistic insight into estrogen's action on blood vessels. By contrast, the vascular effects of androgens remain poorly understood and have been controversial for a long time. In recent years, an increasing body of evidence has suggested that androgens may exert protective effects against the development of atherosclerosis, at least in elderly men. Epidemiological studies have shown that the incidence of and mortality due to CVD were increased in elderly men with low testosterone levels, although the efficacy of androgen therapy remains unknown. Furthermore, recent experimental studies have demonstrated the direct action of androgens on the vasculature. In this review, we illustrate the effects of sex steroids on the cardiovascular system, focusing on the action of testosterone on the blood vessels.

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Section: Hrt and Cvdmentioning

confidence: 99%

Hormonal effects on blood vessels

Akishita

2012

Hypertens Res

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“…11 For example, a review of the 2003 issues of JAMA and NEJM revealed that only 12 percent of studies of drug therapies used non-experimental methods. 12 While previous non-experimental studies of hormone replacement therapy in postmenopausal women had suggested that such treatment provided cardiovascular benefits (Grady et al, 1992;Barrett-Connor & Grady, 1998;Grodstein et al, 2000), recent evidence from randomized trials suggested that such treatment instead increases the risk for cardiovascular disease and breast cancer (Hulley et al, 1998;Women's Health Initiative, 2002). clinical trial would be, an informative RCT on this topic is not likely to be available in the foreseeable future, if ever.…”

Section: Should Health Policymakers Limit Access To Ssris For Depressmentioning

confidence: 99%

Anti-depressants, suicide, and drug regulation

Ludwig

Marcotte

2005

J. Pol. Anal. Manage.

131

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“…An estrogen replacement therapy also increases the risk of endometrial cancer [4], which is reduced by additional progestin administration [5]. The strong belief that HRT will reduce the risk for cardiovascular diseases [6,7] has been challenged by the finding of increased fatal heart attacks in women with pre-existing arteriosclerosis [8,9]. Experimental and clinical investigations about the effects of phytoestrogens on the cardiovascular system show inconsistent results [10,11].…”

Section: Introductionmentioning

confidence: 99%

The Cimicifuga preparation BNO 1055 vs. conjugated estrogens in a double-blind placebo-controlled study: effects on menopause symptoms and bone markers

2003

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Objectives: In the present study, therapeutic effects of the Cimicifuga racemosa preparation CR BNO 1055 (Klimadynon † /Menofem † ) on climacteric complaints, bone metabolism and endometrium will be compared with those of conjugated estrogens (CE) and placebo. The question whether CR BNO 1055 contains substances with selective estrogen receptor modulator (SERM) activity will be investigated. Methods: Sixty-two evaluable postmenopausal women were included in the double-blind, randomized, multicentre study, and treated either with CR BNO 1055 (daily dose corresponding to 40 mg herbal drug), 0.6 mg CE, or matching placebo, for 3 months. Menopausal symptoms were assessed by the menopause rating scale (MRS) and a diary. Levels of CrossLaps (marker of bone degradation) were determined by ELECSYS system and bone-specific alkaline phosphatase (marker of bone formation) by an enzymatic assay. Endometrial thickness was measured via transvaginal ultrasound; vaginal cytology was also studied. The primary efficacy criterion was the change from baseline to end point in the MRS. Change from baseline was analyzed for the secondary variables too. Results: CR BNO 1055 proved to be equipotent to CE and superior to placebo in reducing climacteric complaints. Under both preparations, beneficial effects on bone metabolism have been observed in the serum. CR BNO 1055 had no effect on endometrial thickness, which was significantly increased by CE. Vaginal superficial cells were increased under CE and CR BNO 1055 treatment. Conclusion: The results concerning climacteric complaints and on bone metabolism indicate an equipotent effect of CR BNO 1055 in comparison to 0.6 mg CE per day. It is proposed that CR BNO 1055 contains substances with SERM activity, i.e. with desired effects in the brain/ hypothalamus, in the bone and in the vagina, but without exerting uterotrophic effects. #

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A prospective observational study of postmenopausal hormone therapy and primary prevention of cardiovascular disease

Cited by 142 publications

References 0 publications

Hormonal effects on blood vessels

Hormonal effects on blood vessels

Anti-depressants, suicide, and drug regulation

The Cimicifuga preparation BNO 1055 vs. conjugated estrogens in a double-blind placebo-controlled study: effects on menopause symptoms and bone markers

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