Postmenopausal hormone therapy and cardiovascular disease: Making sense of the evidence

Abstract

Controversy surrounding the cardioprotective role of postmenopausal hormone therapy continues. This controversy is fueled in part by the body of evidence that indicates a duality of hormone therapy on potential risks and benefits. The totality of evidence indicates that the effects of postmenopausal hormone therapy are affected by age, state of the target tissue, duration of therapy, and timing of initiation, according to time since menopause. This review presents evidence supporting a cardioprotective role of hormone therapy in young postmenopausal women as well as a potentially negative effect in older postmenopausal women. These data are reviewed in relation to the evidence that hormone therapy prevents new onset diabetes mellitus, and that the risks of hormone therapy are rare and even rarer in young postmenopausal women. The cardioprotective role of postmenopausal hormone therapy will only be resolved by refined research guided by the results from previous studies.