American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Diagnosis and Treatment of Menopause

AACE Menopause Guidelines Revision Task Force


Endocr Pract. 2006;12(3):315-337. 

In This Article

Conclusions for HT in Prevention of Cardiovascular Disease

  1. Epidemiologic and observational studies suggest that cardioprotection is provided by use of HT—especially for estrogen alone (without a progestin)—when it is prescribed for women early during the menopausal transition (LOE 2b, 2c).

  2. RCTs that have demonstrated no cardioprotective benefit of HT were studies of postmenopausal women more than 10 years beyond the menopausal transition (mean age of mid-60s—an older patient population that would be expected to have a higher incidence of subclinical CAD at initiation of HT) (LOE 1).

  3. RCTs used a fixed-dose, single-form, combined HT. Therefore, these results cannot be applied to other HT regimens.

  4. There is no evidence of increased CAD risk, nor are there RCTs that support a primary cardioprotective benefit, when HT is initiated during the menopausal transition for symptomatic women.

  5. HT should not be initiated for the secondary prevention of CAD (grade D).


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