KEEPS: The Kronos Early Estrogen Prevention Study

@article{Harman2005KEEPSTK,
  title={KEEPS: The Kronos Early Estrogen Prevention Study},
  author={Sherman Mitchell Harman and Eliot A. Brinton and Marcelle I. Cedars and Rogerio A. Lobo and JoAnn E. Manson and George R. Merriam and Vasco Morosini Miller and Fredrick Naftolin and Nanette F Santoro},
  journal={Climacteric},
  year={2005},
  volume={8},
  pages={12 - 3}
}
Observational studies have indicated that hormone therapy given at or after menopause is linked to substantial reduction in cardiovascular disease and its risk factors. Recent findings from the Women's Health Initiative (WHI) clinical trial, however, indicate that combined estrogen plus progestin hormone therapy, as well as estrogen-alone hormone therapy (given to women without a uterus), is ineffective in preventing the new onset of cardiac events in previously healthy late menopausal women… 
Routes of administration of hormone replacement therapy and cardiovascular effects in postmenopausal women.
TLDR
The cardiovascular effects of hormone replacement therapy with different routes of administration in postmenopausal women with results from The Kronos Early Estrogen Prevention Study (KEEPS) is highlighted.
Management of Estrogen Deficiency
TLDR
This chapter highlights the endogenous effect of estrogen on vasculature and cardiac biomarkers, as well as the current research regarding risks and benefits of exogenous hormone therapy in relation to coronary heart disease, venous thromboembolism, stroke, and diabetes.
Long-Term Prevention with Hormone-Replacement Therapy after the Menopause: Which Women should be Targeted?
TLDR
A critical mass of data points toward a protective influence of HRT on cardiovascular disease end points in early postmenopausal women, but increased harm in elderly women, especially those with abdominal adiposity or metabolic syndrome.
Cardiovascular health and the menopausal woman : the role of estrogen and when to begin and end hormone treatment
Reports have correlated the use of estrogen for the treatment of menopausal symptoms with beneficial effects on the cardiovascular system. Molecular, biochemical, preclinical, and clinical studies
Cardiovascular health and the menopausal woman: the role of estrogen and when to begin and end hormone treatment
TLDR
A prevention-based holistic approach is proposed for timely and continuing MHT/ET administration as part of the general management of the menopausal woman, but this should be undertaken only with scheduled, annual patient visits including evaluations of cardiovascular status.
The Kronos Early Estrogen Prevention Study (KEEPS): what have we learned?
TLDR
KEEPS and its ancillary studies have supported the value and safety of the use of HT in recently postmenopausal women and provide a perspective for future research to optimize HT and health of post menopause women.
The Kronos Early Estrogen Prevention Study (KEEPS): what have we learned?
TLDR
KEEPS and its ancillary studies have supported the value and safety of the use of HT in recently postmenopausal women and provide a perspective for future research to optimize HT and health of post menopause women.
Lessons from KEEPS: the Kronos Early Estrogen Prevention Study
TLDR
Although MHT did not decrease the age-related increase in CIMT, KEEPS provided other important insights about MHT effects, including type, dose, and mode of delivery of MHT recently after menopause and how genetic variants in hormone metabolism may affect MHT efficacy on specific outcomes.
Invited commentary: hormone therapy and risk of coronary heart disease why renew the focus on the early years of menopause?
TLDR
The implication of the timing hypothesis for clinical practice is not that recently menopausal women be given hormone therapy for coronary heart disease prevention but rather that clinicians can be reassured about cardiac risks when considering short-term use of hormone Therapy for vasomotor symptom relief in such women.
Prevention of cardiovascular events in early menopause: a possible role for hormone replacement therapy.
TLDR
The objective of this work was to review the current understanding of the relationships between cardiovascular disease risk factors and hormonal age-related changes in postmenopausal women for a more appropriate evaluation of the expected effects of therapy with exogenous estrogens in a specific sample of the large population of post menopausal women.
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References

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TLDR
The primary hypothesis was that unopposed ERT significantly reduces the progression of subclinical atherosclerosis in healthy postmenopausal women without preexisting cardiovascular disease.
Postmenopausal Hormone Replacement Therapy and the Primary Prevention of Cardiovascular Disease
TLDR
This systematic review and meta-analysis examined the value of HRT for the primary prevention of CVD, CAD, or both among postmenopausal women and whether bias might explain discordant results between recent trials and the observational literature.
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TLDR
Estrogen plus progestin does not confer cardiac protection and may increase the risk of CHD among generally healthy postmenopausal women, especially during the first year after the initiation of hormone use.
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TLDR
The use of conjugated equine estrogen (CEE) increases the risk of stroke, decreases therisk of hip fracture, and does not affect CHD incidence in postmenopausal women with prior hysterectomy over an average of 6.8 years, indicating no overall benefit.
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TLDR
Overall, the average rate of progression of subclinical atherosclerosis was slower in healthy postmenopausal women taking unopposed ERT with 17beta-estradiol than in women taking placebo.
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TLDR
Overall health risks exceeded benefits from use of combined estrogen plus progestin for an average 5.2-year follow-up among healthy postmenopausal US women, and the results indicate that this regimen should not be initiated or continued for primary prevention of CHD.
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  • T. Bush
  • Medicine
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TLDR
The Heart and Oestrogen/Progestin Replacement (HERS) Study is a secondary prevention trial testing the protective effect of hormone therapy in women with documented CAD, and may definitively answer the question of whether hormones protect against CAD.
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TLDR
There is evidence that estrogen therapy decreases risk for coronary heart disease and for hip fracture, but long-term estrogen therapy increases risk for endometrial cancer and may be associated with a small increase in risk for breast cancer.
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TLDR
Current estrogen use is associated with a reduction in the incidence of coronary heart disease as well as in mortality from cardiovascular disease, but it is not associated with any change in the risk of stroke.
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TLDR
The results of pooled data do not support the notion that postmenopausal hormone therapy prevents cardiovascular events, and the numbers of reported events were too low for a useful conclusion.
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