Hormonal
Initiating postmenopausal hormone therapy (conjugated equine estrogens with or without medroxyprogesterone acetate) within 10 years of menopause onset is associated with a reduced risk of coronary heart disease (CHD), whereas initiating therapy 20 or more years after menopause increases CHD risk.
If you are considering hormone therapy for menopausal symptoms, the timing matters significantly for heart disease risk. Starting therapy within 10 years of menopause may lower your risk of coronary heart disease, but starting more than 20 years after menopause may increase that risk. However, note that stroke risk appears to increase regardless of when you start. Discuss your specific cardiovascular risk factors and the timing of menopause with your doctor to weigh the benefits of symptom relief against these risks.
For women with less than 10 years since menopause began, the hazard ratio (HR) for CHD was 0.76 (95% confidence interval [CI], 0.50-1.16); 10 to 19 years, 1.10 (95% CI, 0.84-1.45); and 20 or more years, 1.28 (95% CI, 1.03-1.58) (P for trend=.02).
Why this rating
Secondary analysis of large randomized controlled trials (WHI) with high statistical power for subgroup trends, though the primary trend for CHD by age was not significant.
Source
Postmenopausal Hormone Therapy and Risk of Cardiovascular Disease by Age and Years Since Menopause
Jacques E. Rossouw et al. · JAMA · 2007
DOI 10.1001/jama.297.13.1465
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