Doctors should not recommend that post-menopausal women start hormone replacement therapy (HRT) just to prevent cardiovascular events. Also, women at particular risk of blood clots should be discouraged from using HRT to prevent cardiovascular events.
Post-menopausal women are at higher risk of cardiovascular disease (CVD) than younger women. There are sound biological arguments why giving post-menopausal women extra oestrogen might protect them from CVD, and various uncontrolled studies appear to confirm this idea. However, the question of whether HRT has a long-term benefit for women at risk of CVD is unresolved.
To answer this, Cochrane Review Authors drew on data from 10 large, well run studies. Pooling the results they were able to compare the effects of giving HRT to 12,353 women, with giving placebos to 11,930 other women.
They concluded that giving HRT does not protect post-menopausal women from CVD. In addition, women who have specific risks that may make them prone to suffer from blood clots should be discouraged from taking HRT at all.