Early HRT Doesn't Reduce Heart Risk
Starting Hormone Therapy Around Menopause Offers No Decrease in Risk of Heart Disease
WebMD News Archive
Hormone Therapy and the Heart continued...
Compared to women randomized to the placebo arm of the trial, women who
commenced combined hormone therapy within 10 years of menopause had a slight
increase in heart disease risk during the first two years of use, but this
increase in risk did not reach statistical significance and was considered
Perhaps the more important finding was that there was clearly no evidence of
a protective effect.
“The available evidence suggests that estrogen plus progestin therapy does
not reduce the risk for coronary heart disease during the first 3 to 6 years of
use in women who initiated therapy close to menopause,” Toh and colleagues
write. “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 heart disease.”
Is Today’s Hormone Therapy Safer?
Hormone therapy researcher JoAnn Manson, MD, who was a principal
investigator for the WHI trial, tells WebMD that women taking hormone
treatments today for menopausal symptoms may have a lower risk for
treatment-related side effects than the women in the original trial.
That’s because the women who participated in the WHI intervention trial were
taking much higher doses of estrogen than women typically take today and they
took them for longer periods.
It is generally believed, but has not been proven in clinical studies, that
the lower-dose hormone formulations widely used today are safer than the
higher-dose formulations used a decade ago.
Many women now use a low-dose hormone patch, which has been shown to have a
lower risk for blood clots.
“There is always a trade-off when you take any drug,” says Manson, who is
chief of the division of preventive medicine at Boston’s Brigham and Women’s
Hospital. “But it is important to point out that heart disease is not common in
women around the time of menopause. Their risk is very low.”
Manson agrees with the current recommendation that women experiencing
troubling menopausal symptoms take hormones in the lowest effective doses for
the shortest duration possible.