Figure 10.

The Early versus Late Intervention Trial with Estradiol (ELITE) was specifically designed to test the hormone replacement therapy timing hypothesis comparing oral estradiol with or without vaginal progesterone with placebo in two strata of women who were at the time of randomization <6 years-since-menopause (<6 ysm) or ≥10 years-since-menopause (≥10 ysm) (23). After median 5-year intervention, women in the early postmenopause stratum (<6 ysm) showed a statistically significant reduction in progression of subclinical atherosclerosis measured by carotid artery intima-media thickness with hormone replacement therapy relative to placebo; 0.0044 versus 0.0078 mm per year (p=0.008), respectively (27). Among women in the late postmenopause stratum (≥10 ysm), rates of atherosclerosis progression were similar in the hormone replacement therapy and placebo groups; 0.0088 versus 0.0100 mm per year (p=0.29), respectively. The effect of hormone replacement therapy on subclinical atherosclerosis progression significantly differed between the early postmenopause stratum and the late postmenopause stratum (P=0.007 for interaction) (27).