Study Conflicts – Does Hormone Replacement Therapy HRT
Cause Heart Attacks Strokes or Breast Cancer?
February 13th 2006
A study in 2002 showed an increase risk of breast cancer, stroke and
heart attack for women that took hormone replacement therapy (HRT). The
researchers looked at the data from the Women’s Health Initiative (WHI),
which began in the early 90’s with nearly 50,000 women. Their findings
left women with a tough decision: Should they continue with the risky
HRT or should they stop?
They found that women had a 30% increased risk of heart attack when
taking HRT. Now a follow up study has reevaluated the data, and found
no increased risk of heart attack when women take estrogen alone,
The research, published in the February 13th issue of archives of
Internal Medicine – one of JAMA/Archives journals, said “Estrogen
therapy does not appear to reduce the risk of heart attack or coronary
death in healthy postmenopausal women, although some data suggest a
lower coronary heart disease risk in women aged 50 to 59 years”.
There were 10,739 participants between the age of 50 and 79 who
underwent a hysterectomy. Of these women, some were given either a
conjugated equine estrogen (mix of several estrogens) or a placebo. The
researchers were planning on 8.5 year study but it was stopped in March
of 2004 after only 6.8 years, because the estrogen only treatment
appeared to increase the risk of stroke.
Judith Hsia, M.D., of George Washington University, Washington, D.C.,
and colleagues looked at the data and found the risk of coronary death
was almost the same for women taking estrogen only and for those taking
the placebo. Although there was no significant reduction in heart
attacks, coronary revascularization (reestablishment of blood supply to
the heart) was “less frequent” among women taking the estrogen.
The authors report “This trial may have been unable to demonstrate a
significant difference in the risk of myocardial infarction or coronary
death by age group because of the low event rate in young women.”
According to Dr. Lila Nachtigall, ob-gyn at the New York University
Medical, “I have never seen women suffering as much from symptoms of
menopause as I have now. This paper helps us feel that overall,
estrogen alone did no harm to women as far as heart disease."
Natchigall also pointed out that estrogen may have a small benefit to
heart vessels. HRT may help prevent atherosclerosis (plaque) buildup in
the arteries, but not remove plaque that is already there.
Another study, the four-year Kronos Early Estrogen Prevention Study,
will try to determine whether estrogen slows hardening of the arteries
in younger women. It will include 720 women ages 42 to 48. The
researchers will also try to determine whether the estrogen skin patch
is more effective than an estrogen pill.
Best Syndication Staff Writer
Books on Heart Disease
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