Postmenopausal Hormone Therapy and Atherosclerosis — Time Is of the Essence

Multiple prospective cohort studies in the 1980s indicated that hormone therapy was associated with a nearly 50% lower risk of coronary heart disease in postmenopausal women,1 which prompted speculation that such therapy could be used to prevent coronary events. However, subsequent large-scale randomized trials that evaluated the effect of postmenopausal hormone therapy failed to support the presence of a cardiovascular benefit. Among women with established coronary heart disease, combined estrogen–progestin therapy resulted in an increased risk of coronary heart disease events at 1 year and had no significant effects on the risk of coronary heart disease events in longer-term follow-up. . . .