Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2004 Jul;19(7):791-804.
doi: 10.1111/j.1525-1497.2004.30281.x.

Mortality associated with hormone replacement therapy in younger and older women: a meta-analysis

Shelley R Salpeter  1 , Judith M E Walsh, Elizabeth Greyber, Thomas M Ormiston, Edwin E Salpeter
Affiliations
Review

Mortality associated with hormone replacement therapy in younger and older women: a meta-analysis

Shelley R Salpeter et al. J Gen Intern Med. 2004 Jul.

Abstract

Objective: To assess mortality associated with hormone replacement in younger and older postmenopausal women.

Design: A comprehensive search of MEDLINE, CINAHL, and EMBASE databases was performed to identify randomized controlled trials of hormone replacement therapy from 1966 to September 2002. The search was augmented by scanning selected journals through April 2003 and references of identified articles. Randomized trials of greater than 6 months' duration were included if they compared hormone replacement with placebo or no treatment, and reported at least 1 death.

Measurements: Outcomes measured were total deaths and deaths due to cardiovascular disease, cancer, or other causes. Odds ratios (OR) for total and cause-specific mortality were reported separately for trials with mean age of participants less than and greater than 60 years at baseline.

Main results: Pooled data from 30 trials with 26,708 participants showed that the OR for total mortality associated with hormone replacement was 0.98 (95% confidence interval [CI], 0.87 to 1.12). Hormone replacement reduced mortality in the younger age group (OR, 0.61; CI, 0.39 to 0.95), but not in the older age group (OR, 1.03; CI, 0.90 to 1.18). For all ages combined, treatment did not significantly affect the risk for cardiovascular or cancer mortality, but reduced mortality from other causes (OR, 0.67; CI, 0.51 to 0.88).

Conclusions: Hormone replacement therapy reduced total mortality in trials with mean age of participants under 60 years. No change in mortality was seen in trials with mean age over 60 years.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Odds ratios for total mortality associated with hormone replacement therapy: trials with mean age of participants less than 60 years.
FIGURE 2
FIGURE 2
Odds ratios for total mortality associated with hormone replacement therapy: trials with mean age of participants greater than 60 years.
See this image and copyright information in PMC

Comment in

References

    1. Wolf PH, Madans JH, Finucane FF, Higgins M, Kleinman JC. Reduction of cardiovascular disease-related mortality among postmenopausal women who use hormones: evidence from a national cohort. Am J Obstet Gynecol. 1991;164:489–94. - PubMed
    1. Grodstein R, Stampfer JJ, Colditz GA, et al. Postmenopausal hormone therapy and mortality. N Engl J Med. 1997;336:1769–75. - PubMed
    1. Bush TL, Barrett-Conner E, Cowan LD, et al. Cardiovascular mortality and contraceptive use of estrogen in women: results from the Lipid Research Clinics Program Follow-up Study. Circulation. 1987;75:1102–9. - PubMed
    1. Sourander L, Rajala T, Raiha I, Makinen J, Ekkola R, Helenius H. Cardiovascular and cancer morbidity and mortality and sudden cardiac death in postmenopausal women on oestrogen replacement therapy (ERT) Lancet. 1998;352:1965–9. - PubMed
    1. Petitti DB, Perlman JA, Sidney S. Noncontraceptive estrogens and mortality: long-term follow-up of women in the Walnut Creek Study. Obstet Gynecol. 1987;70:289–93. - PubMed