Hormone replacement therapy and cardiovascular disease: increased risks of venous thromboembolism and stroke, and no protection from coronary heart disease

Lowe, G. D. O.

doi:10.1111/j.1365-2796.2004.01400.x

Cited by 54Menopause: Health Impacts and TreatmentsVenous Thromboembolism Diagnosis and ManagementHormonal and reproductive studies

Hormone replacement therapy and cardiovascular disease: increased risks of venous thromboembolism and stroke, and no protection from coronary heart disease

Lowe, G. D. O.·2004·Journal of Internal Medicine

DOI 10.1111/j.1365-2796.2004.01400.x

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Abstract

Hormone replacement therapy (HRT) was increasingly promoted over the last 40 years to improve quality of life, and to reduce the risks of osteoporotic fractures and coronary heart disease (CHD). In recent years, observational studies, randomized trials and systematic reviews of such trials have shown that HRT does not reduce, but actually increases cardiovascular risk. HRT increases the relative risks of venous thromboembolism (twofold), and of fatal or disabling stroke (by 50%); whilst increasing the early risk of myocardial infarction and having no protective effect against CHD on longer term use. Possible mechanisms for these increased cardiovascular risks include down-regulation of several inhibitory pathways of blood coagulation, resulting in increased coagulation activation, which promotes venous and arterial thrombosis. The implications for prescription are discussed, as are lessons for future evaluation of health care interventions.

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Authors: Lowe, G. D. O.
Affiliations: University of Glasgow (GB)
Corresponding author: Lowe, G. D. O.
ORCID: Lowe, G. D. O.
Venue: Journal of Internal Medicine
Publisher: Wiley
Published: 2004-10-15
Volume: 256
Issue: 5
Pages: 361-374
ISSN: 0954-6820 (ISSN-L)
1365-2796
DOI: 10.1111/j.1365-2796.2004.01400.x
OpenAlex: W2086773243
Cited by: 54
References: 152
Citations by year: 2025: 3 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 5 · 2020: 1 · 2019: 1 · 2015: 3 · 2014: 2 · 2013: 2 · 2012: 2
FWCI: 1.09
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Journal of Internal Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords: hormone replacement therapy, cardiovascular disease, venous thromboembolism, stroke, coronary artery disease, myocardial infarction, coagulation, thrombosis risk, osteoporotic fractures
MeSH terms: Blood Coagulation Disorders, Coronary Disease, Female, Forecasting, Humans, Risk Factors, Thromboembolism, Randomized Controlled Trials as Topic, Practice Guidelines as Topic, Venous Thrombosis, Hormone Replacement Therapy, Stroke

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Hormone replacement therapy and cardiovascular disease: increased risks of venous thromboembolism and stroke, and no protection from coronary heart disease

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