HRT may Prevent Heart Attacks in Women
Reported April 24, 2006
(Ivanhoe Newswire) — Hormone replacement therapy can reduce heart attacks by about one-third in women under age 60 but has mixed results for older women, according to researchers from Cornell and Stanford universities.
Investigators conducted a statistical analysis of 23 trials with more than 39,000 women and found when women in their 50s started HRT (estrogen with or without progesterone) to relieve menopausal symptoms, death decreased by 32 percent compared to those receiving a placebo or no treatment. For women over 60, however, HRT increased the risk of heart attacks in the first year of treatment, but after two years on the treatment the risk of heart attacks began to reduce.
Edwin Salpeter, an astrophysicist and professor of physical sciences at Cornell University in Ithica, N.Y., says, “Varying reports on the risks and benefits of HRT have generated confusion for women.” He says one reason for this is because the Women’s Health Initiative (WHI) initially reported that HRT was linked to more heart attacks when they analyzed the sample as a whole in women with a mean age of 63, rather than breaking down women’s ages after menopause. This information is important because younger women may respond differently to HRT than older women. Since then, Salpeter says the WHI researchers have provided data for coronary heart disease events for younger and older women separately.
“We pooled the data from the two WHI trials for younger women with all other randomized placebo-controlled trials and found a statistically significant 32-percent reduction in coronary heart disease events for women who start treatment in their 50s,” says Shelley Salpeter, lead study author and clinical professor of medicine at Stanford’s School of Medicine in Calif.
An earlier paper published by the father-daughter Salpeter pair may explain why younger women react differently to HRT. In the earlier study, they found HRT significantly reduces the risk of diabetes when compared to the placebo but increases the levels of protein associated with inflammation of the body. This may reduce heart attacks in younger women without heart disease but increase the risks for older women who already have cardiovascular disease.
SOURCE: Journal of General Internal Medicine, 2006;21:s4