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. 2017 Jan 17;2017(1):CD004143. doi: 10.1002/14651858.CD004143.pub5

Comparison 1. Women without major health problems (selected outcomes: death, CVD, cognition, QOL).

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 Death from any cause: oestrogen‐only HT 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.1 Oestradiol 1 mg (low dose) for 2 years 1 222 Risk Ratio (M‐H, Fixed, 95% CI) 0.33 [0.01, 8.10]
1.2 CEE 0.625 mg (mod dose) for 7.1 years 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 1.03 [0.88, 1.20]
1.3 CEE 0.625 mg (mod dose) for 10.7 years (includes extra follow‐up) 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 1.02 [0.91, 1.13]
2 Death from any cause: combined HT 5   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
2.1 CEE 0.625 mg (mod dose) + MPA 2.5 mg for mean/median 1 year 2 20993 Risk Ratio (M‐H, Fixed, 95% CI) 1.31 [0.76, 2.27]
2.2 CEE 0.625 mg (mod dose) + MPA 2.5 mg for 2 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.05 [0.71, 1.56]
2.3 CEE 0.625 mg (mod dose) + P (as per footnotes) for 3 years 3 18075 Risk Ratio (M‐H, Fixed, 95% CI) 1.09 [0.81, 1.46]
2.4 CEE 0.045 mg (lowish dose) + 200 mg sequential progesterone for 4 years 1 505 Risk Ratio (M‐H, Fixed, 95% CI) 3.58 [0.15, 87.57]
2.5 CEE 0.625 mg (mod dose) + MPA 2.5 mg for 5.6 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.00 [0.84, 1.19]
2.6 CEE 0.625 mg (mod dose) + MPA 2.5 mg for 7.9 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.06 [0.93, 1.20]
2.7 CEE 0.625 mg (mod dose) + MPA 2.5 mg after 13.2 years (includes extended follow‐up) 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.00 [0.92, 1.08]
3 Death from any cause: oestrogen with or without sequential progesterone vaginal gel 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
3.1 Oestradiol 1 mg daily, with or without cyclic 4% vaginal progesterone gel 1 643 Risk Ratio (M‐H, Fixed, 95% CI) 0.99 [0.06, 15.77]
4 Death from coronary heart disease: oestrogen‐only HT 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
4.1 Oestradiol 1 mg (low dose) daily for 2 years 1 222 Risk Ratio (M‐H, Fixed, 95% CI) 0.33 [0.01, 8.10]
4.2 CEE 0.625 mg (mod dose) for 7.1 years 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 0.98 [0.69, 1.38]
4.3 CEE 0.625 mg (mod dose) after 10.7 years (includes extra follow‐up) 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 0.92 [0.71, 1.19]
5 Death from coronary heart disease: combined continuous HT 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
5.1 CEE 0.625 mg (mod dose) + MPA 2.5 mg for mean 5.6 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.06 [0.68, 1.66]
5.2 CEE 0.625 mg (mod dose) + MPA 2.5 mg for mean 7.9 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 0.99 [0.72, 1.38]
6 Death from coronary heart disease: combined sequential HT 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
6.1 1 mg 17‐B‐oestradiol (low dose) daily plus (3 days weekly) 0.35 mg norethindrone for 2 years 1 142 Risk Ratio (M‐H, Fixed, 95% CI) 0.34 [0.01, 8.27]
7 Death from stroke: oestrogen‐only HT 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
7.1 CEE 0.625 mg (low dose) for 7.1 years 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 1.16 [0.58, 2.32]
8 Death from stroke: combined sequential HT 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
8.1 1 mg 17‐B‐oestradiol (low dose) daily plus (3 days weekly) 0.35 mg norethindrone for 2 years 1 142 Risk Ratio (M‐H, Fixed, 95% CI) 3.08 [0.13, 74.46]
9 Death from stroke: combined continuous HT 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
9.1 CEE 0.625 mg (mod dose) + MPA 2.5 mg for median 1 year 1 4385 Risk Ratio (M‐H, Fixed, 95% CI) 2.99 [0.12, 73.37]
9.2 CEE 0.625 mg (mod dose) + MPA 2.5 mg for mean 5.6 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.04 [0.46, 2.35]
10 Death from colorectal cancer: oestrogen‐only HT 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
10.1 CEE 0.625 mg (mod dose) for 7.1 years 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 1.28 [0.66, 2.46]
11 Death from breast cancer: combined continuous HT 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
12 Death from breast cancer: oestrogen‐only HT 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
12.1 CEE 0.625 mg (mod dose) after median 11.8 years (includes extra follow‐up) 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 0.38 [0.15, 0.98]
13 Death from colorectal cancer: combined continuous HT 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
13.1 CEE 0.625 mg (mod dose) + MPA 2.5 mg for mean 5.6 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 0.95 [0.40, 2.29]
13.2 CEE 0.625 mg (mod dose) + MPA 2.5 mg for 7.1 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.01 [0.52, 1.96]
13.3 CEE 0.0625 mg (mod dose) + MPA 2.5 mg after 11.6 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.31 [0.80, 2.14]
14 Death from lung cancer: oestrogen‐only HT (moderate dose) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
14.1 Death from lung cancer (non‐small cell or small cell) 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 1.05 [0.65, 1.70]
14.2 Death from non‐small cell lung cancer 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 0.88 [0.52, 1.50]
14.3 Death from small cell lung cancer 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 2.04 [0.62, 6.79]
15 Death from lung cancer: combined continuous HT (moderate dose) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
15.1 Death from lung cancer (non‐small cell or small cell) at mean 7.9 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.74 [1.18, 2.55]
15.2 Death from non‐small cell lung cancer at mean 7.9 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.91 [1.24, 2.93]
15.3 Death from small cell lung cancer at mean 7.9 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.16 [0.48, 2.81]
15.4 Death from lung cancer (any type) at median 14 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.10 [0.88, 1.39]
16 Death from lung cancer: combined sequential HT (low dose oestrogen) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
16.1 1 mg 17‐B‐oestradiol (low dose) daily plus (3 days weekly) 0.35 mg norethindrone for 2 years 1 142 Risk Ratio (M‐H, Fixed, 95% CI) 3.08 [0.13, 74.46]
17 Death from any cancer: combined continuous HT 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
17.1 CEE O.625 mg daily (mod dose) + MPA 2.5 mg for 3 years 1 777 Risk Ratio (M‐H, Fixed, 95% CI) 2.77 [0.11, 67.80]
17.2 CEE 0.625 mg daily (mod dose) + MPA 2.5 mg for mean 5.2 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.16 [0.87, 1.53]
18 Coronary events (MI or cardiac death): oestrogen‐only HT 3   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
18.1 Oestradiol 1 mg (low dose) for 2 years 1 222 Risk Ratio (M‐H, Fixed, 95% CI) 0.5 [0.05, 5.43]
18.2 CEE 0.625 mg (mod dose) for 3 years 1 349 Risk Ratio (M‐H, Fixed, 95% CI) 2.98 [0.12, 72.72]
18.3 CEE 0.625 mg (mod dose) for mean 7.1 years 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 0.94 [0.78, 1.13]
18.4 CEE 0.65 (mod dose) for 10.7 years (includes extra follow‐up) 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 0.95 [0.82, 1.10]
19 Coronary events (MI or cardiac death): combined continuous HT 3   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
19.1 CEE 0.625 mg (mod dose) + MPA 2.5 mg for mean/median 1 year 2 20993 Risk Ratio (M‐H, Fixed, 95% CI) 1.89 [1.15, 3.10]
19.2 CEE 0.625 mg (mod dose) + MPA 2.5 mg for 2 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.49 [1.05, 2.12]
19.3 CEE 0.625 mg (mod dose) + MPA 2.5 mg for 3 years 2 17385 Risk Ratio (M‐H, Fixed, 95% CI) 1.45 [1.07, 1.98]
19.4 CEE 0.625 mg (mod dose) + MPA 2.5 mg for mean 5.6 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.17 [0.95, 1.44]
19.5 CEE 0.625 mg (mod dose) + MPA 2.5 mg after 13.2 years (includes extended follow‐up) 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.08 [0.95, 1.22]
20 Coronary events (MI or cardiac death): combined sequential HT 3   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
20.1 CEE 0.625 mg (mod dose) daily + micronised progesterone 200 mg days 1‐12 for 3 years 1 352 Risk Ratio (M‐H, Fixed, 95% CI) 4.89 [0.24, 101.09]
20.2 1 mg (low dose) 17‐B‐oestradiol daily plus (3 days weekly) 0.35 mg norethindrone for 2 years 1 142 Risk Ratio (M‐H, Fixed, 95% CI) 0.34 [0.01, 8.27]
20.3 Oestradiol patch 0.05 mg (mod dose) + 200 mg sequential progesterone for 4 years 1 497 Risk Ratio (M‐H, Fixed, 95% CI) 3.71 [0.15, 90.70]
21 Coronary events (MI or cardiac death): oestrogen with or without sequential progesterone vaginal gel 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
21.1 Oestradiol 1 mg daily, with or without cyclic 4% vaginal progesterone gel 1 643 Risk Ratio (M‐H, Fixed, 95% CI) 0.33 [0.03, 3.16]
22 Stroke: unopposed oestrogen 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
22.1 Oestradiol 1 mg (low dose) for 2 years 1 222 Risk Ratio (M‐H, Fixed, 95% CI) 3.0 [0.12, 72.86]
22.2 CEE 0.625 mg (mod dose) for mean 7.1 years 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 1.33 [1.06, 1.67]
22.3 CEE 0.625 mg (mod dose) for 10.7 years (includes extra follow‐up) 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 1.17 [0.97, 1.40]
23 Stroke: combined continuous HT 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
23.1 CEE 0.625 mg (mod dose) + MPA 2.5 mg for 1 year 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 0.95 [0.49, 1.86]
23.2 CEE 0.625 mg (mod dose) + MPA 2.5 mg for 2 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.31 [0.83, 2.06]
23.3 CEE 0.625 mg (mod dose) + MPA 2.5 mg for 3 years 2 17385 Risk Ratio (M‐H, Fixed, 95% CI) 1.46 [1.02, 2.09]
23.4 CEE 0.625 mg (mod dose) + MPA 2.5 mg for mean 5.6 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.39 [1.09, 1.77]
23.5 CEE 0.625 mg (mod dose) + MPA 2.5 mg for mean 7.9 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.29 [1.06, 1.56]
23.6 CEE 0.625 mg (mod dose) + MPA 2.5 mg after 13.2 years (includes extended follow‐up) 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 1.15 [0.99, 1.33]
24 Stroke: combined sequential HT 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
24.1 1 mg (low dose) 17‐B‐oestradiol daily plus (3 days weekly) 0.35 mg norethindrone for 2 years 1 142 Risk Ratio (M‐H, Fixed, 95% CI) 3.08 [0.13, 74.46]
24.2 CEE 0.625 mg (mod dose) daily + MPA 10 mg days 1‐12 for 3 years 1 348 Risk Ratio (M‐H, Fixed, 95% CI) 3.0 [0.12, 73.14]
25 Stroke: combined sequential HT 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
25.1 CEE 0.625 mg (mod dose) daily + micronised progesterone 200 mg days 1‐12 for 3 years 1 352 Risk Ratio (M‐H, Fixed, 95% CI) 2.93 [0.12, 71.51]
26 Transient ischaemic attack: oestrogen‐only HT 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
26.1 Oestradiol 1 mg (low dose) for 2 years 1 222 Risk Ratio (M‐H, Fixed, 95% CI) 3.0 [0.12, 72.86]
27 Transient ischaemic attack: combined sequential HT 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
27.1 1 mg 17‐B‐oestradiol (low dose) daily plus (3 days weekly) 0.35 mg norethindrone for 2 years 1 142 Risk Ratio (M‐H, Fixed, 95% CI) 1.03 [0.07, 16.13]
27.2 CEE 0.625 mg (mod dose) daily + MPA 10 mg days 1‐12 for 3 years 1 348 Risk Ratio (M‐H, Fixed, 95% CI) 3.0 [0.12, 73.14]
28 Transient ischaemic attack: oestrogen with or without sequential progesterone vaginal gel 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
28.1 Oestradiol 1 mg daily,with or without cyclic 4% vaginal progesterone gel 1 643 Risk Ratio (M‐H, Fixed, 95% CI) 0.50 [0.05, 5.44]
29 Stroke or transient ischaemic attack 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
29.1 CEE 0.625 mg (mod dose) + MPA 2.5 mg for mean/median 1 year 1 4385 Risk Ratio (M‐H, Fixed, 95% CI) 0.73 [0.37, 1.46]
30 Venous thromboembolism (DVT or PE): oestrogen‐only HT 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
30.1 CEE 0.625 mg (mod dose) for up to 2 years 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 2.22 [1.12, 4.39]
30.2 CEE 0.625 mg (mod dose) for 3 years 1 349 Risk Ratio (M‐H, Fixed, 95% CI) 6.96 [0.36, 133.75]
30.3 CEE 0.625 mg (mod dose) for 7.1 years 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 1.32 [1.00, 1.74]
30.4 CEE 0.625 mg (mod dose) for 10.7 years (includes extra follow‐up) 1 10739 Risk Ratio (M‐H, Fixed, 95% CI) 1.04 [0.84, 1.29]
31 Venous thromboembolism (DVT or PE): combined sequential HT 3   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
31.1 1 mg 17‐B‐oestradiol (low dose) daily plus (3 days weekly) 0.35 mg norethindrone for 2 years 1 142 Risk Ratio (M‐H, Fixed, 95% CI) 3.08 [0.13, 74.46]
31.2 CEE 0.625 mg (mod dose) daily + MPA 10 mg days 1‐12 for 3 years 1 348 Risk Ratio (M‐H, Fixed, 95% CI) 3.0 [0.12, 73.14]
31.3 CEE 0.045 mg (lowish dose) + 200 mg sequential progesterone for 4 years 1 505 Risk Ratio (M‐H, Fixed, 95% CI) 0.40 [0.02, 9.73]
31.4 Oestradiol patch 0.05 mg (mod dose) + 200 mg sequential progesterone for 4 years 1 497 Risk Ratio (M‐H, Fixed, 95% CI) 1.24 [0.08, 19.69]
32 Venous thromboembolism (DVT or PE): combined continuous HT 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
32.1 CEE 0.625 mg (mod dose) + MPA 2.5 mg for mean/median 1 year 2 20993 Risk Ratio (M‐H, Fixed, 95% CI) 4.28 [2.49, 7.34]
32.2 CEE 0.625 mg (mod dose) + MPA 2.5 mg for 2 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 2.98 [1.88, 4.71]
32.3 CEE 0.625 mg (mod dose) + MPA 2.5 mg for 3 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 2.54 [1.73, 3.72]
32.4 CEE 0.625 mg (mod dose) + MPA 2.5 mg for mean 5.6 years 1 16608 Risk Ratio (M‐H, Fixed, 95% CI) 2.03 [1.55, 2.64]
32.5 CEE 0.625 mg (mod dose) + 2.5 mg MPA for mean 7.9 years 1 16707 Risk Ratio (M‐H, Fixed, 95% CI) 1.65 [1.32, 2.05]
33 Venous thromboembolism (DVT or PE): oestrogen with or without sequential progesterone vaginal gel 1   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
33.1 Oestradiol 1 mg daily, with or without cyclic 4% vaginal progesterone gel 1 643 Risk Ratio (M‐H, Random, 95% CI) 1.49 [0.25, 8.83]
34 Global cognitive function 4   Mean Difference (Fixed, 95% CI) Subtotals only
34.1 Transdermal estradiol 0.014 mg (low dose): MMSE scores (baseline MMSE ≤ 90) 1   Mean Difference (Fixed, 95% CI) ‐1.21 [‐5.05, 2.63]
34.2 Transdermal estradiol 0.014 mg (low dose): MMSE scores (baseline MMSE > 90) 1   Mean Difference (Fixed, 95% CI) ‐0.3 [‐0.73, 0.13]
34.3 CEE 0.625 mg (mod dose) with or without 2.5 mg MPA for 3 years: MMSE scores 1   Mean Difference (Fixed, 95% CI) ‐0.1 [‐0.35, 0.15]
34.4 CEE 0.625 mg (mod dose) for mean 5.2 years: MMSE scores 1   Mean Difference (Fixed, 95% CI) ‐0.26 [‐0.52, 0.00]
34.5 Combined continuous CEE 0.625 mg (mod dose) + MPA 2.5 mg for mean 4.2 years: MMSE scores 1   Mean Difference (Fixed, 95% CI) ‐0.18 [‐0.36, 0.00]
34.6 Oestrogen with or without sequential progesterone vaginal gel 1   Mean Difference (Fixed, 95% CI) ‐0.03 [‐0.21, 0.15]
35 Probable dementia 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
35.1 CEE 0.625 mg (mod dose) for 5.2 years 1 2947 Risk Ratio (M‐H, Fixed, 95% CI) 1.52 [0.89, 2.59]
35.2 Combined continuous CEE 0.625 mg (mod dose) + MPA 2.5 mg for mean 4.05 years 1 4532 Risk Ratio (M‐H, Fixed, 95% CI) 1.97 [1.16, 3.33]