Hormones and Cardiovascular Disease
Director: Pierre-Yves Scarabin

 

Hormones and Cardiovascular Disease
Director: Pierre-Yves Scarabin

 

Hormones and Cardiovascular Disease
Director: Pierre-Yves Scarabin

 

The UK study by Vinogradova Y et al included about 6.000 postmenopausal women who had venous thromboembolism (VTE) and 22.000 controls coming from 2 large cohorts (General Practice and Clinical Practice Research Datalink (CPRD) databases). Women who used oral estrogen had a significantly increased VTE risk compared with non users. Compared with no exposure, conjugated equine oestrogen with medroxyprogesterone acetate had the highest risk and estradiol with dydrogesterone had the lowest risk. As previously reported, transdermal preparations were not associated with VTE risk. This study shows that the vast majority of women using HRT continue to be prescribed oral preparations. It is concluded that women - especially obese women or with VTE history- and their doctors should give greater consideration to transdermal HRT, in line with the clinical guidelines. 

Surprisingly, the impact of progesterone on VTE risk is not discussed in this study. There is strong evidence that progesterone has no effect on clotting factors and resistance to activated protein C. Furthermore, an updated meta-analysis has recently shown that among transdermal oestrogen users, progesterone was the safest progestogen with respect to VTE risk. See Letter to Editor

 

 

© Esther 2019