Menopausal Hormone Therapy: Putting the Timing Hypothesis to the Test

The timing hypothesis postulates that hormone therapy (HT) either has little effect on or hastens progression of atherosclerosis in women a decade or more past menopause onset but slows atherosclerotic progression in recently menopausal women. To test this hypothesis, investigators for the Early versus Late Intervention Trial with Estradiol (ELITE) randomized 643 healthy women (<6 years or ≥10 years past menopause) without cardiovascular disease (CVD) to oral estradiol or placebo for 6 to 7 years.

The first and last participants were randomized in 2005 and 2008, respectively. To assess HT's impact on subclinical atherosclerosis, the investigators have monitored carotid artery intima-media thickness (CIMT) and performed cardiac computed tomog…