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QUESTION: What is the effectiveness of postmenopausal hormone replacement therapy (HRT) for primary prevention of cardiovascular disease?
Studies were identified by searching Medline and Cochrane databases from 1966 to December 2000 and by reviewing bibliographies of relevant studies and other publications.
Studies were selected if they were randomised controlled trials (RCTs), cohort studies, or case control studies that assessed the use of HRT for primary prevention of cardiovascular disease in postmenopausal women and if English language abstracts were available.
Data were extracted on study design, type of HRT (unopposed oestrogen or oestrogen plus progestin), definitions of cardiovascular disease, and potential risk factors included in multivariate models. 2 investigators independently assessed the quality of individual studies. Formal review and meta-analysis were limited to studies of good or fair quality and included RCTs, cohort studies with internal controls, and population based case control studies with ≥3 years of follow up. HRT use was classified as current, past, ever, or any (combined current, past, or ever).
Only the results for coronary artery disease (CAD) incidence are reviewed …