Hormonal
Postmenopausal women using combined estrogen and progestin therapy experience a marked decrease in the risk of major coronary heart disease compared to non-users, with the addition of progestin not attenuating the cardioprotective effects of estrogen.
For postmenopausal women considering hormone therapy, current use of combined estrogen and progestin is associated with a significantly lower risk of major coronary heart disease compared to not using hormones. The addition of progestin does not appear to cancel out the heart-protective benefits of estrogen.
We observed a marked decrease in the risk of major coronary heart disease among women who took estrogen with progestin, as compared with the risk among women who did not use hormones (multivariate adjusted relative risk, 0.39; 95 percent confidence interval, 0.19 to 0.78)... The addition of progestin does not appear to attenuate the cardioprotective effects of postmenopausal estrogen therapy.
Why this rating
Large prospective cohort study (Nurses' Health Study, N=59,337) with long follow-up (up to 16 years) and multivariate adjustment, though observational design limits causal inference compared to RCTs.
Source
Postmenopausal Estrogen and Progestin Use and the Risk of Cardiovascular Disease
Francine Grodstein et al. · New England Journal of Medicine · 1996
DOI 10.1056/nejm199608153350701
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