I was recording a podcast session with today (see next week), and she provided an intriguing article from BMJ on the cardiovascular outcomes using various forms of HRT.
The study evaluated almost 1 million women who were younger than original HRT trials and received various forms of HRT. This was a Swedish cohort, and the investigation was possible due to 1) unique registry system that exists in Sweden and 2) applying a novel technique of multiple emulated trials to the observational cohort. They found that transdermal applications, which have increased in use during 2007-2020 have no impact on CV outcomes (MI, CVA, VTE, ischemic heart disease) while oral formulations had increased the risks. Tibolone, which is a synthetic steroid not available in the US was also associated with adverse outcomes except VTE.
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