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. Author manuscript; available in PMC: 2017 Apr 15.
Published in final edited form as: Circ Res. 2016 Apr 15;118(8):1273–1293. doi: 10.1161/CIRCRESAHA.116.307547

Figure 3. Menopausal Hormone Therapy Timeline.

Figure 3

Experimental studies have consistently demonstrated beneficial physiologic effects of estrogen on the vascular endothelium at the cellular and molecular level. This long-standing observation led to a hypothesis that estrogens were cardioprotective, which was initially supported by retrospective and prospective observational studies, followed by disappointment from HERS, WHI and other RCTs that failed to demonstrate reduced risks of clinical CVD events with MHT. More recent RCTs include KEEPS (null results) and ELITE (which has supported the “timing hypothesis”). MHT is contraindicated for the primary and secondary prevention of CVD.