Hormone Replacement Therapy and Postmenopausal Cardiovascular Events: A Meta-Analysis
نویسندگان
1 Department of Cardiology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
2 Department of Parasitology, Faculty of Medicine, Shiraz University of Medical Sciences, Fars, Iran
3 Department of Cardiac Surgery, Yasuj University of Medical Sciences, Yasuj, Iran
4 Department of Cardiology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
5 Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
doi
10.5812/ircmj.82298چکیده
Context: Hormone replacement therapy (HRT) is widely used to control postmenopausal symptoms. This therapy is also used to pre-vent diseases such as osteoporosis and dementia. However, clinical trials suggest some negative effects regarding postmenopausalHRT. This study evaluates the effects of HRT on postmenopausal cardiovascular events.Evidence Acquisition: We collected data from 32 articles by using valid keywords and searching databases of PubMed, Medlib,ScienceDirect, EmBase, Scopus, Index Copernicus, SID, and Iranmedex. Analysis was performed by comparing three groups of post-menopausal women: combined hormone therapy (estrogen + progesterone), estrogen alone treated group, and placebo-receivinggroup (control group). Data were analyzed using the random effect model meta-analysis by using R software and Stata softwareVersion 11.2.Results: Of the collected 32 studies between 1998 and 2016, there were 1277686 subjects with an average age of 60.6 years. The preva-lence of myocardial infarction were (2.64%), coronary heart disease (1.7%), stroke (254%), cardiovascular death (1.54%), revasculariza-tion (3.26 %), and cerebrovascular disease (CVD) (2.78%) in the combined hormone therapy group. Also, in the estrogen-treated groupwere 2.95%, 3.41%, 2.49%, 2.8%, - , 3.14%, respectively. In the placebo-receiving group these events were 2.09%, 2.73%, 2.9%, 2.25%, 4.96%,and 11.92, respectively. The results showed that estrogen therapy could increase the incidence of stroke. Moreover, HRT could havepositive effects on the serum lipid profile in postmenopausal women.Conclusion: Postmenopausal HRT appears to be non-effective on coronary artery disease, revascularization, myocardial infarction,and cardiac-related deaths; however, it could play a role in increasing the stroke rate.
