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Therapeutics
Review: postmenopausal oestrogen replacement therapy increases the risk for venous thromboembolism

https://doi.org/10.1136/ebm.7.5.138

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    (2002) Ann Intern Med 136, 680; Miller J, Chan BK, Nelson HD.. Postmenopausal estrogen replacement and risk for venous thromboembolism: a systematic review and meta-analysis for the U.S. Preventive Services Task Force.. May 7;. :. –90.
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 QUESTION: In postmenopausal women receiving hormone replacement therapy (HRT), what is the risk for venous thromboembolism (VTE)?

    Data sources

    Studies were identified by searching Medline (1966 to 2000), HealthSTAR (1975 to 2000), and the Cochrane Controlled Trials Register, and by scanning the bibliographies of relevant studies and reviews.

    Study selection

    Studies were selected if they were published in English or had English-language abstracts, enrolled postmenopausal women, and reported deep venous thrombosis, pulmonary embolism, or VTE as adverse events related to oestrogen use. Studies that selected participants on the basis of previous thromboembolic events or risk for thrombosis were excluded.

    Data extraction

    Data were extracted on participants, treatment (for randomised controlled trials [RCTs]), definition and method for determining exposure (for case control and cohort studies), event rates, confounders, outcome measurement, and study duration. 2 reviewers independently rated study quality.

    Main results

    12 trials were included: 3 RCTs, 8 case control studies, and 1 cohort study. Risk for …

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    Footnotes

    • Sources of funding: Agency for Healthcare Research and Quality; Portland Veterans Affairs Medical Center Women’s Health Fellowship.

    • For correspondence: Dr J Miller, Oregon Health and Science University, Portland, Oregon, USA. millerji{at}ohsu.edu.