The current literature, combined with improved methodology in the WISE study, suggests that there is a beneficial relation between HT use and IHD in peri- and early postmenopausal women. Our results are also consistent with recent clinical trials that have failed to show benefit of HT initiation in older postmenopausal women, either for angiographic coronary disease or cardiac events. Overall, our data suggest that the anti-atherosclerotic effect of HT, if present, may be age-dependent and primarily evident in relatively younger peri- and early postmenopausal women. © 2010.