What condition involves significant risks, including stroke and VTE, when considering hormone replacement therapy?

The condition that involves significant risks when considering hormone replacement therapy (HRT) includes obesity, history of coronary artery disease (CAD), and active liver disease, making the comprehensive answer to factor in all these conditions.

Obesity is associated with a higher risk of venous thromboembolism (VTE) as excess body weight can lead to increased pressure in the pelvic and leg veins, disrupting normal blood flow and making clot formation more likely. Additionally, obesity is linked to various metabolic dysfunctions that can complicate HRT.

A history of coronary artery disease (CAD) indicates a prior event or risk for cardiovascular issues. The use of hormone replacement therapy can potentially increase the risk of adverse cardiovascular events, including myocardial infarction and stroke. Estrogen in particular has been noted to have both beneficial and harmful effects on vascular health, depending on multiple factors including the patient's existing health conditions.

Active liver disease poses a critical risk due to the liver's role in metabolizing hormones. Patients with compromised liver function can experience disrupted hormone clearance, leading to elevated hormone levels and an increased risk of thrombotic events. Furthermore, certain liver diseases can make patients hypercoagulable, further raising the risks associated with estrogen therapy.

Given the substantial implications for health and wellbeing