For women who already have cardiovascular disease (CVD):
1) Hormone Replacement Therapy (HRT) should not be initiated for the secondary prevention of CVD.

2) The decision to continue or stop HRT in women with CVD who have been undergoing long-term HRT should be based on established noncoronary benefits and risks and patient preference.

3) If a woman develops an acute CVD event, such as a heart attack or stroke, or is immobilized while undergoing HRT, it is prudent to consider discontinuance or HRT or to consider anticoagulant prophylaxis while she is hospitalized to minimize the risk or blood clots associated with immobilization.  Reinstitution of HRT should be based on established non-coronary benefits and risks, as well as patient preference.

For women who do not have cardiovascular disease:

1)      Firm clinical recommendations for primary prevention await the results of ongoing, randomized clinical trials.

2)      There is insufficient data to suggest that HRT should be initiated for the sole purpose of primary prevention of CVD.

3)      Initiation and continuation of HRT should be based on established non-coronary benefits and risk, possible coronary benefits and risks, and patient preference.

Lori Mosca, Peter Collins, David M. Herrington, Michael E. Mendelsohn, Richard C. Pasternak, Rose Marie Robertson, Karin Schenck-Gustafsson, Sidney C. Smith, Jr, Kathryn A. Taubert, and Nanette K. Wenger.   Hormone Replacement Therapy and Cardiovascular Disease: A Statement for Healthcare Professionals From the American Heart Association.  Circulation 24 July 2001; 104(4): 499-503

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