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01.06.2005 | Review Article

Hormone Replacement Therapy and Risk of Acute Myocardial Infarction

A Review of the Literatures

verfasst von: Susan E. Bromley, Dr Corinne S. de Vries, Dawn Thomas, Richard D.T. Farmer

Erschienen in: Drug Safety | Ausgabe 6/2005

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Abstract

Many animal studies and studies on intermediate clinical endpoints have shown hormone replacement therapy (HRT) to be associated with both favourable and unfavourable cardiovascular effects. We reviewed the literature regarding HRT and the distinct endpoint of acute myocardial infarction (AMI) in peri- and postmenopausal women.

Searches of the MEDLINE and EMBASE databases were conducted. Fifty papers were identified as eligible for inclusion: eight randomised controlled trials, 18 cohort studies, 23 case-control studies and one case-control and cohort study.

The single large primary prevention randomised controlled trial on HRT and the risk of AMI in generally healthy women (Women’s Health Initiative trial) reported a small yet significantly increased risk of AMI in postmenopausal women receiving combined HRT. This contrasts with a large number of observational studies that suggested a protective effect, although in many of these studies the results were not statistically significant. Inconclusive evidence on the effect of duration of use does not support the notion that a possible protective association is causal. Detection bias and residual confounding are alternative explanations for the associations observed in the randomised controlled trial and observational studies. No studies on groups of women with existing cardiovascular disease or with diabetes mellitus, including the only large secondary prevention trial (Heart and Estrogen/Progestin Replacement Study), reported a significant change in AMI risk between HRT users and non-users.

There is insufficient evidence to suggest that HRT is associated with a change in the risk of AMI in the majority of women. However, certain subgroups of women with specific genetic polymorphisms may be more susceptible to a change in the risk of AMI with HRT use.

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Titel: Hormone Replacement Therapy and Risk of Acute Myocardial Infarction
A Review of the Literatures
verfasst von: Susan E. Bromley
Dr Corinne S. de Vries
Dawn Thomas
Richard D.T. Farmer
Publikationsdatum: 01.06.2005
Verlag: Springer International Publishing
Erschienen in: Drug Safety / Ausgabe 6/2005
Print ISSN: 0114-5916
Elektronische ISSN: 1179-1942
DOI: https://doi.org/10.2165/00002018-200528060-00002

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Hormone Replacement Therapy and Risk of Acute Myocardial Infarction

A Review of the Literatures

Abstract

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

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