By Susan Brinkmann, OCDS
Staff Journalist
A new study from the Women’s Health Initiative (WHI) confirms that combination hormone therapy increases the risk of heart disease in healthy postmenopausal women.
Researchers at the WHI, which is sponsored by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH), found a trend toward an increased risk of heart disease during the first two years of hormone therapy among women who began therapy within 10 years of menopause. They also found a more marked elevation of risk among women who began hormone therapy (HT) more than 10 years after menopause.
The bottom line is that overall a woman’s risk of heart disease more than doubles within the first two years of taking combination HT.
“Today, most women who take hormone therapy for menopausal symptoms begin therapy shortly after menopause,” said Susan B. Shurin, M.D., NHLBI acting director. “Based on today’s report, even these women appear to be at increased risk of heart disease for several years after starting combination hormone therapy.”
The difference in the initial level of risk does not appear related to age, based on findings that the increased risk of heart disease was similar between women in their 50s on combination hormone therapy and women in their 60s.
Combination hormone therapy includes progestin in combination with estrogen. Adding progestin is known to prevent endometrial cancer in women with a uterus. These findings do not apply to women who have had a hysterectomy and take estrogen-only hormone therapy. Similar analyses on the results of the clinical trial of estrogen only therapy are planned.
The WHI is a major 15-year research program designed to address the most frequent causes of death, disability, and poor quality of life in postmenopausal women: cardiovascular disease, cancer, and osteoporosis.
The principal findings from the latest hormone therapy trials, which studied 27,347 postmenopausal women on estrogen plus progestin, estrogen-alone, or placebo, found that the overall risks of long-term use of hormone therapy outweigh the benefits. Both of these trials were stopped early because of increased health risks and failure to prevent heart disease, a key question of the studies.
Dr. Shurin warns: “It is more clear than ever that women who are considering postmenopausal hormone therapy for menopausal symptoms should discuss their risk of heart disease and other risks — such as breast cancer, stroke, and dangerous blood clots — with their doctors before starting therapy.”
The study is in the Feb. 16, 2010 issue of Annals of Internal Medicine.
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