Relation Between Timing of Starting Hormone Therapy and CVD Risk Unclear

A secondary subgroup analysis from the Women's Health Initiative offers no clear answer on the question of whether starting hormone therapy closer to menopause carries less cardiovascular risk than initiating therapy later.
The study, reported in JAMA, included data on some 27,000 WHI participants. It found that hormone use was associated with a nonsignificant reduction in risk for coronary heart disease among women who started therapy within 10 years of menopause, but with increases in CHD risk among women who started therapy 10 to 19 years, or 20 or more years after menopause. Hormone therapy was associated with elevated stroke risk in all three groups.
The data "suggest that the effect of hormones on CHD may be modified by years since menopause" the authors write, but this trend was not statistically significant. Still, they write, the findings "are consistent with current recommendations that hormone therapy be used in the short-term for relief of moderate or severe vasomotor symptoms, but not in the longer term for prevention of cardiovascular disease."
Link: JAMA article (Free abstract; full text requires subscription)