Health outcomes of hormone therapy initiated or continued after age 65

Initiation of HT after age 65 is linked to significantly increased risks of cancer and vascular events, supporting current guidelines discouraging late initiation. While HT may offer some cardiovascular benefits when started earlier, use in older women should involve individualized risk-benefit assessment and close monitoring. These findings underscore the need to align clinical practice with evolving evidence and guideline recommendations. Given the retrospective design, incomplete pre-2000 medical history, and potential residual confounding, findings should be interpreted with caution.