Menopause and CHD

[BoraBora]

I just went to UpToDate and now it seems that there might not be a strong association between menopause and CHD. Not only that, but HRT is not recommended for CHD. Does anyone know about this or can find supporting evidence for this in the literature.

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[tiredmom]

Check out the Women's Health Initiative study - that's probably what they are referring to. It's a huge prospective trial that found that women on HRT had a higher rate of coronary events than those not on hrt. There are some flaws in the study - the biggest being that the avg age of women put on the hrt was pretty old (relatively speaking) than the perimenopausal women we put on hrt now. They stopped the estrogen/progesterone arm because of the coronary data. Currently, HRT is only recommended for the perimenopausal hot flash symptoms.