Early Hormone Therapy Safe for Women's Hearts?
Hormone replacement started soon after menopause wasn't linked to hardening of the arteries in study
The women's average age was nearly 53 but ranged from 42 to 58. Their last menstrual period was within 36 months before the study start. The average time since the start of menopause was 1.4 years, according to the study.
Over the course of the study period, Harman's team evaluated markers of heart disease risk. They looked at changes in the thickness of the wall of the common carotid artery in the neck, using ultrasound. This can predict heart attack and stroke risk. They looked at the appearance of new calcium deposits in the heart arteries. They looked also at blood pressure, cholesterol and blood sugar levels.
The investigators found few differences among groups for build-up of plaque and other markers of heart disease risk. The oral dose group had decreased levels of LDL ("bad") cholesterol and increased HDL ("good") cholesterol. But they also had increased triglycerides, another type of blood fat that may increase the risk of heart disease.
The patch group seemed to have better blood sugar levels, the study authors noted.
Hormone replacement therapy has also been linked with increased breast cancer risk, but this study only looked at its effect on heart health.
"Mostly they are confirming what we already know," said Dr. Kellie Flood-Shaffer, division director of obstetrics and gynecology at University of Cincinnati College of Medicine.
The research ''seems to have taken more measurements reflecting cardiovascular disease risk than other studies," she said.
"I think they are showing, at least from a vascular standpoint, we can at least keep [heart disease] at bay," she said, at least in the younger, healthy women.
The study findings point to the need to individualize decisions on hormone replacement therapy based on each person's risk factors, she said. For instance, if a woman has a family history of heart disease, high LDL and bothersome symptoms, she might prescribe hormone therapy.