Estradiol-based postmenopausal hormone therapy and risk of cardiovascular and all-cause mortality.

One of the benefits of HRT in the menopause is the reduction in strokes and heart attacks. Over 1/2 of all women over 50 will die from a heart attack, so this benefit of HRT is very significant, and often overlooked when discussing whether to take HRT or not.

Menopause. 2015 Sep;22(9):976-83. doi: 10.1097/GME.0000000000000450.

Estradiol-based postmenopausal hormone therapy and risk of cardiovascular and all-cause mortality.

Author information

  • 11Department of Obstetrics and Gynecology, Helsinki University, Helsinki University Hospital, Helsinki, Finland 2Folkhälsan Research Center, Helsinki, Finland 3EPID Research Oy, Espoo, Finland 4National Institute for Health and Welfare, Helsinki, Finland 5Nordic School of Public Health, Gothenburg, Sweden.



Data on the health benefits and risks of postmenopausal hormone therapy (HT) are derived mainly from the use of conjugated equine estrogens. Estradiol-based regimens may have a different risk-benefit profile. We evaluated the risk of death caused by coronary heart disease (CHD), stroke, or any disease among users of estradiol-based HT regimens in a nationwide study in Finland.


A total of 489,105 women who used HT from 1994 to 2009 (3.3 million HT exposure years), as indicated in the nationwide reimbursement register and the national Cause of Death Register, were followed. A total of 28,734 HT users died during follow-up; among the deaths, 3,843 were caused by CHD and 2,464 were caused by stroke. Mortality risk in HT users with varying duration of exposure (≤1 y, >1 to 3 y, >3 to 5 y, >5 to 10 y, or >10 y) was compared with that in an age-matched background population.


Risk of CHD death was significantly reduced by 18% to 54% in HT users and was positively related to HT exposure time. Risk of stroke death was also reduced by 18% to 39%, but this reduction was not clearly related to HT exposure time. Risk of all-cause mortality was reduced in HT users by 12% to 38%, almost in linear relationship with duration of exposure. All these risk reductions were comparable in women initiating HT before age 60 years and women initiating HT at age 60 years or older.


In absolute terms, the risk reductions mean 19 fewer CHD deaths and 7 fewer stroke deaths per 1,000 women using any HT for at least 10 years.

About Dr Colin Holloway

Gp interested in natural hormone treatment for men and women of all ages

Posted on September 11, 2016, in Uncategorized. Bookmark the permalink. 1 Comment.

  1. Hello Dr Holliway… I was a patient of yours, I think I took the hormone treatments for about 4 years.. I found they served my purpose , but it was a shock 2. Years ago at the age of 56 I had a stroke…probably nor related at all.. Turned out to be a 100% blocked carotid artery. I was originally a smoker & I did consume a lot of meat. So saying that I am constantly monitoring my vascular health & eating a plant based, mostly, diet. ( hard living with a meat & 3 Vege )

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