On February 15, 2010 the NIH issued a news release about a new analysis reported in the Annals of Internal Medicine on data from the Women's Health Initiative (WHI).  The study reevaluated whether or not combination hormone therapy (estrogen+progestin) increases the risk of heart disease in healthy postmenopausal women. Researchers from the National Heart, Lung, and Blood Institute (NHLBI) and the Harvard School of Public Health reanalyzed data from the WHI, comparing the effects of hormone therapy (HT) on heart disease risk among women who began hormone therapy within 10 years of menopause to women who began therapy more that 10 years after menopause. Recently, there has been a lot of debate among clinicians and researchers whether or not the time between the start of menopause and the initiation of hormone treatment affects the cardiovascular risk.  Some believed that the risk may not be present in women who start HT shortly after they go into menopause.  In this new study,  the researchers compared women who started combination hormone (estrogen+progestin) treatment within 10 years of menopause to women who began therapy more than 10 years after menopause and examined the impact on heart disease over time (up to eight years). The new study did not include women who took estrogen only.

The researchers reported a trend toward a possible increased risk of heart disease in the first two years among the women who started hormone therapy within 10 years after menopause and the increased risk persisted in this group an average of 6 years, after which those in the treatment group appeared to have a lower risk of heart disease compared to similar women who were not on combination hormone therapy.  In contrast, women who started hormone therapy 10 years or more after menopause were nearly 3 times more likely to develop heart disease within the first two years of treatment compared to women on placebo.   These women continued to be at increase risk of health disease throughout the 8 years of follow-up.

Jacques E. Rossouw, MD, chief of the NHLBI Women's Health Initiative Branch and a coauthor of the paper, added,  "Although the number of recently menopausal women who would be expected to suffer a heart attack during the first years of combination HT is small, the risk is likely to be real." In the NHLBI press release, acting director, Susan B. Shurin, MD, said, "Today, most women who take hormone therapy for menopausal symptoms begin therapy shortly after menopause.  Based on today's study, even these women appear to be at increased risk of heart disease for several years after starting combination hormone therapy."  This new data reinforces the need for women to  discuss their potential risk for cardiovascular disease and for other conditions like stroke and  breast cancer with their doctors when considering combination HT.

So what have we learned from this study?    Women who start combination HT to treat the symptoms of menopause within 10 years of menopause, should not expect the treatment to protect them from heart attacks, and may even have a possible slight increase in risk.   As with many studies, the statistical significance of the women in the study may not be sufficient to make this the final word on the topic but it is unlikely that additional information on the scale of this study will be available in the near future.

Tags: 

Comments

A lot of these studies appear to be helpful for the layman person, but as a scientific person, it would be more helpful if the number needed to treat was published. Sometimes, many drugs they only cause around a 3-4% decrease in likihood of the chance to get a certain disease if its taken over an x amount of years. Could you provide this ifno with your article as well? I would like to know these figures for the HT treatment. Thanks

I was searching this site for information about HRT when I came across this post. For many reasons I was beginning to think HRT would be a viable treatment for me, but since I'm 9 years post menopausal it doesn't seem worth the risk. I will certainly discuss this post with my doctor and appreciate the information.

Is HRT reduce the risk of heart disease? I don't think so, In certain studies young women heart disease can be protected by hormone therapy. Am i right? Thanks

I know its hard to separate women with aging issues, but in Japan menopause is not even heard of there. Why do HT with the risk of heart problems later on, just be more active and love yourself. Besides the study isn't so clear on the data.

I wonder how many people participated in the study? Plus I'm sure there are several other factors that would help a patient be able to establish a statistical significance of risk and be better able to make an informed decision. Seems like a big gray area so far, but as with anything...there is always a risk/reward.

Ever wonder why we have a “healthcare” industry and not a “healthcure” industry?

If you are a woman who smokes you may also be interested in the effects of smoking in relation to women's health, including menopause issues. Take a look at the web site side effects smoking dot net and click the gender tab on the right for women's issues. I do hope this is helpful.

Maybe if the study was done in a more control group there can be a clearer result if HT done during menopause does increase the chance of heart attack

Has there been any studies and support to show that HRT is the cause of Heart Disease?

as with most studies, there is rarely an obvious result. you could fill your office shelves with the conflicting reports of almost any health or health care issue.

My wife has been on HRT treatment now for the past 3 and half years, She's only been in menopause in the last 4 years. I've always believed that HRT is the best treatment option for menopausal symptoms until i read your post. Beside's this isn't the only report i've read about this perceived risk of cardiovascular risks from the use of HRT. And this is beginning to concern my wife and I. Thanks for the info.

This is very alarming. I thought I should relay this info to my mother who's been in the midst of menopausal stage today. Thanks a lot.

Both subcutaneous fat and visceral fat in the abdominal area are serious health risk factors, but science has shown that having excessive visceral fat is even more dangerous than subcutaneous fat. Both of them greatly increase the risk your risk of developing heart disease, diabetes, high blood pressure, stroke, sleep apnea, various forms of cancer, and other degenerative diseases.

ah.. i am on this blog again. looks like your blog is very famous. I was looking for this information on google. Thank you again for great and useful information... really nice.

Great post. This can be a good warning for women who have been thinking of using the combination HT that they are not completely safe from having heart attacks, and in fact, they are slightly at risk. Good information.

Thanks for this article. I wonder if there are natural vitamins/supplements that would help minimize the negative effects of taking hormones. I am a big believer in natural alternatives.

This is a very informative post. However, is is true that HRT reduce the risk of heart disease? I have never heard anything like that before, and I am reading a lot about this topic... EDITOR'S NOTE: There is ongoing research about HRT and Heart disease....the timing of HRT seems to play a role. More to come.

Very interesting and alarming I have not yet hit menopause but I am 43 yrs old. Time to start looking into these matters.

Hello there! This article could not be written any better! Going through this article reminds me of my previous roommate! He continually kept talking about this. I am going to forward this information to him. Pretty sure he'll have a very good read. I appreciate you for sharing!

Add new comment

CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.