Postmenopausal Hormone Therapy and Mortality

Grodstein, Francine; Stampfer, Meir J.; Colditz, Graham A.; Willett, Walter C.; Manson, JoAnn E.; Joffe, Marshall M.; Rosner, Bernard; Fuchs, Charles S.; Hankinson, Susan E.; Hunter, David J.; Hennekens, Charles H.; Speizer, Frank E.

doi:10.1097/00006254-199711000-00021

Cited by 312 publications

(428 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: 98%

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: 98%

Hormonal effects on blood vessels

Akishita

2012

Hypertens Res

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“…Hot flashes, anxiety, insomnia, and osteoporosis are among the major complications often associated with this phase in a woman's life. Hormone replacement therapy (HRT) is effective in alleviating a number of menopausal symptoms (Grodstein et al, 1997;Henderson, 1997). Indeed, Premarin ® , a naturally occurring mixture of estrogens produced from equine urine, is commercially one of the most successful pharmaceutical preparations of all time.…”

Section: Introductionmentioning

confidence: 99%

The pharmacognosy of Humulus lupulus L. (hops) with an emphasis on estrogenic properties

2006

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SummaryAs the population ages, there is an ever-increasing need for therapeutic agents that can be used safely and efficaciously to manage symptoms related to postmenopausal estrogen deficiency. Endogenous estrogens, e.g., 17β-estradiol, of exogenous mammalian origin, e.g., horses, have long been used to manage such symptoms. There are more than twenty different classes of phytochemicals that have demonstrated affinity for human estrogen receptors in vitro. Some studies on exogenous estrogenic substances of botanical origin ("phytoestrogens"), such as standardized formulations of plant extracts with in vitro and in vivo estrogenic activity from soy (Glycine max Merill.) and red clover (Trifolium pratense L.), suggest clinical efficacy. Few clinical data for phytoestrogens other than isoflavonoids are available. In an exhaustive review of the literature through 2003, only two clinical trials were identified that were designed to evaluate the effect of hops (Humulus lupulus L.) on symptoms related to manopause. Folkloric, chemical, and biological literature relating primarily to the use of hops for their estrogenic activity, and two human clinical trials, are reviewed.

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“…However, in a randomized placebo controlled trial of HRT in women with coronary heart disease, there was no significant difference between groups in occurrence of non-fatal myocardial infarction or coronary heart disease (Hulley et al, 1998). Concern has been raised about an increased incidence of breast cancer after HRT use, especially after more than 10 years of use (Grodstein et al, 1997). In the collaborative re-analysis of 51 studies the breast cancer risk was found to be increased by 2.3% per year of use and to be greatest during and shortly after discontinuation of HRT (Collaborative Group on Hormonal Factors in Breast Cancer, 1997).…”

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confidence: 99%

Hormone replacement therapy before breast cancer diagnosis significantly reduces the overall death rate compared with never-use among 984 breast cancer patients

et al. 1999

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Summary Nine hundred and eighty-four breast cancer patients were interviewed regarding exogenous hormonal use. This represents a random sample of breast cancer patients in Southern Sweden referred to the Department of Oncology at Lund for treatment between 1978 and 1997 (excluding 1980 and 1981) with a 100% follow-up. Ever-use of hormone replacement therapy (HRT) prior to diagnosis was significantly associated with a longer overall survival in women with their breast cancer diagnosed at ages 45 and above, relative risk (RR) of dying 0.73 (95% confidence interval (CI) 0.62-0.87; P = 0.0005). Ever use of HRT prior to breast cancer diagnosis was significantly positively associated with overall longer survival after adjustment for T-stage, N-stage, M-stage, year of diagnosis and age at diagnosis, RR of dying 0.78 (95% CI 0.65-0.93; P = 0.006). Hormone replacement therapy use and oestrogen receptor positivity were independently significantly associated with overall longer survival, P = 0.005 and P < 0.0001, respectively, in one model. HRT use and progesterone receptor positivity were also independently significantly associated with longer overall survival, P = 0.003 and P = 0.0003, respectively, in another model. The mode of diagnosis was known in 705 women. Mammography screening was not more common among HRT users compared with neverusers, where this information was available. Both mammography screening and HRT use were independently associated with longer survival, P = 0.002 and P = 0.038 respectively.

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Postmenopausal Hormone Therapy and Mortality

Cited by 312 publications

References 0 publications

Hormonal effects on blood vessels

Hormonal effects on blood vessels

The pharmacognosy of Humulus lupulus L. (hops) with an emphasis on estrogenic properties

Hormone replacement therapy before breast cancer diagnosis significantly reduces the overall death rate compared with never-use among 984 breast cancer patients

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