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Timing Key in Hormone Heart Risk

Study: Hormone Therapy May Help Younger Women, Harm Older Ones
WebMD Health News
Reviewed by Louise Chang, MD

April 3, 2007 - Hormone therapy may not pose heart risks for all women, a new report shows.

Starting hormone therapy within 10 years of menopause does not increase a woman’s risk for heart disease, according to a new analysis from the trial that first alerted women to the treatment’s potential health risks.

There was even a suggestion of a reduced risk of heart disease among women under 60 who took estrogen or estrogen plus progestin, but the association could have been due to chance.

Researchers from the National Heart, Lung, and Blood Institute (NHLBI) revisited earlier data from the Women’s Health Initiative (WHI) in an effort to determine if the cardiovascular impact of hormone therapy varied by age or years since the beginning of menopause.

Benefit and Harm

Millions of women abandoned hormones following a WHI report five years ago suggesting an increased risk of heart disease, stroke, breast cancer, and blood clots among older study participants taking estrogen and progestin, compared with women who didn’t take hormones.

The risks have been less clear for women in their late 40s and 50s, who take hormones primarily for hot flashes and other menopause symptoms and are at low risk for heart disease.

In their new report, published Wednesday in TheJournal of the American Medical Association, NHLBI researchers for the first time combined data from the Prempro (estrogen plus progestin) and the Premarin (estrogen alone) arms of the WHI.

The combined analysis confirmed a very different heart disease risk profile among women who take hormones around the time of menopause and those who take them later in life, WHI project officer Jacques Rossouw, MD, tells WebMD.

“With regard to coronary heart risk we saw evidence, although it was not conclusive, that hormone therapy may benefit younger women and harm older women,” he says.

The researchers found no increased risk of heart disease among women who begin hormone therapy within 10 years of the onset of menopause. Taking hormones 20 or more years after menopause or taking them after age 69 was associated with increased heart risk.

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