Hormone therapy in perimenopausal and postmenopausal women: examining the evidence on cardiovascular disease risks.

Women may live for 30 years or longer after menopause with cardiovascular disease as their highest mortality risk. Menopause may correspond to health alterations for women, yet the use of estrogen during and after this transition has been controversial for the past four decades. The evidence from recent scientific studies does not support the use of hormone therapy for the prevention or treatment of cardiovascular disease, which has resulted in its removal from national guideline recommendations. However, because of concerns related to specific aspects of the research, there are gaps in the evidence. Studies are under way to evaluate alternate methods for hormone delivery, low-dose hormone therapy, and selective estrogen receptor modulators (SERMs) in reducing cardiovascular risks in perimenopausal and postmenopausal women. Implications for clinical nursing practice include education as well as assessment and counseling related to individual risk factors.