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Hormone Replacement Therapy (HRT) and Cardiovascular Disease
  Two large studies recently reported that Estrogen/Progestin (HRT) was not protective against cardiovascular disease as thought for many years.  The first study looked at HRT and cardiovascular disease in 2,763 post menopausal women with existing coronary heart disease (CHD). Women were randomly assigned to receive HRT or a placebo. After 6.8 years of study they found no benefit for any cardiovascular outcome between the two groups. They concluded, HRT "Should not be used for the purpose of reducing risk for CHD events in women with CHD." This news is upsetting to millions of women who have been taking HRT thinking that they were reducing their coronary risk.

A second, larger trial of HRT in healthy postmenopausal women, Women's Health Initiative (WHI) study found similar results. They studied 16,608 women, half receiving a placebo and half HRT. The study was planned for 8.5 years but was stopped after 5.2 years because the oversight committee determined the HRT was causing more harm than benefit. Those taking hormones had a 29% increase of coronary heart disease, 41% increase in stroke risk, a 26% increase in risk of invasive breast cancer, and a doubling of risk for pulmonary embolism.

They did see some benefit with a decrease in hip fractures (34%) and colorectal cancer (37%). They had an overall global index that indicated more harm than benefit was occurring. Three large studies now have all found an increase in breast cancer. The Journal article concluded, "Given these results, we recommend that clinicians stop prescribing this combination (HRT) for long-term use."

The third study on estrogen use was on 44,241 postmenopausal women in a breast cancer detection study. They found that those women taking estrogen alone had a 60% increase in ovarian cancer, a very deadly form of cancer that is difficult to treat. The longer women took the estrogen, the higher their risk of cancer. They calculated a 7% increase in risk for every year they took estrogen. Those women who took estrogen and progestin had only a small risk of ovarian cancer. If you are taking HRT or estrogen you need to talk to your doctor about this issue. There are alternative treatments for osteoporosis and heart disease that are safer alternatives to HRT.

 

 

 

Reference

Fletcher SW et al, Failure of estrogen plus progestin therapy for prevention, JAMA Jul 17, 2002; 288:366-8


Making Healthy Choices articles are written by Don Hall, DrPH, CHES president of LifeLong Health with contributions from associated health professionals. Content is general health information from evidence based research. It's purpose is not to treat disease or take the place of advice by your doctor but to promote healthy lifestyles. Persons with health problems should contact their physician for specific guidance.

Copyrighted 2002 by PrevMedix LLC. All rights reserved. Do not make unauthorized copies.

Updated: 12/17/02