Women with no prior history of CVD were at higher risk (HR, 1.73; 95% CI, 1.28 2.33) than women with a prior history (HR, 1.01; 95% CI, 0.58 1.75). Women using HT who were 50 to 59 years of age had a lower of age (HR, 1.72; 95% CI, 1.17 2.54) or those 70 to 79 years of age (HR, 1.52; 95% CI, 1.02 2.29) compared with nonusers. These risk estimates did not vary by race or other baseline risk factors, including aspirin or statin use or BP.19 There is also little compelling evidence that HT is effective at preventing deterioration of cognitive function in postmeno- pausal women. The Women s Health Initiative Memory Study (WHIMS), a subgroup of women enrolled in the WHI, found that for women 65 years of age, HT did not reduce the inci- dence of either dementia or mild cognitive impairment.260,261 HT had an adverse effect on global cognitive function,262,263 which was greater among women with lower cognitive func- tion at initiation of treatment. Subsequent magnetic resonance imaging studies in a subset of these women found greater brain but not a significantly higher volume of subclini- cal cerebrovascular lesions in treated women.265 The adverse effects were most evident in women experiencing cognitive deficits before initiation of HT. Similar results have been reported in randomized clinical trials for selective estrogen receptor modulators and other hormonally active compounds (including raloxifene266,267 and a commonly used therapy in Europe with both estrogenic and androgenic properties). Raloxifene (60 mg ver- sus placebo) had no effect on the risk of nonfatal stroke (HR, 1.10; 95% CI, 0.92 1.32) but increased the risk of fatal strokes (HR, 1.49; 95% CI, 1.00 1.24; P=0.05). 