Cardiac Effects of Hormone Replacement Therapy Studied

No decreased coronary heart disease risk found in women during first years of therapy
By Eric Metcalf
HealthDay Reporter

TUESDAY, Feb. 16 (HealthDay News) -- Hormone replacement therapy that includes estrogen plus progestin may not reduce the risk for coronary heart disease (CHD) during the first several years of treatment in women who started hormone therapy near menopause, according to research published in the Feb. 16 issue of the Annals of Internal Medicine.

Sengwee Toh, of Harvard Medical School in Boston, and colleagues analyzed data from 16,608 postmenopausal women with an intact uterus in the Women's Health Initiative estrogen plus progestin trial who were randomized to receive placebo or conjugated equine estrogens and medroxyprogesterone acetate.

The researchers found that continuous use of estrogen and progestin was associated with a higher risk of CHD for the first two years (hazard ratio, 2.36), as well as a trend toward a higher risk for the first eight years. For women within 10 years after menopause, the hazard ratios were 1.29 and 0.64 for the first two and eight years, respectively, but with confidence intervals including one. For these women, a possible cardioprotective effect was seen only after six years of use.

"In summary, the available evidence suggests that estrogen plus progestin therapy does not reduce the risk for CHD during the first three to six years of use in women who initiated therapy close to menopause. Because the typical duration of use of hormone therapy is short, most women contemplating estrogen plus progestin therapy for the relief of menopausal symptoms should not expect protection against CHD," the authors write.

A co-author reported financial relationships with several pharmaceutical companies.

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