Hormone Replacement Therapy May Be Linked to Heart Attacks
By Richard Shank
Recent research suggests that a decline in the use of Hormone Replacement Therapy (HRT) may be linked to a decrease in the rate of heart attacks in women.
Prior to 2002, HRT had been widely used to counterbalance changes in hormone levels for post-menopausal women. Up to that time, physicians also believed that HRT had the added benefit of reducing the risk of cardiovascular disease. In 2002, however, a report by the Women’s Health Initiative
(http://jama.ama-assn.org/cgi/content/abstract/288/3/321) concluded that the inverse relationship was true. The latest study appears to confirm the initial suspicions of the researchers behind the Women’s Health Initiative report.
In this study, researchers at the RAND Corporation analyzed data from 1990 to 2005 that studied women between the ages of 40 and 79. They used national death records, the Healthcare Cost and Utilization Project, and national surveys of medication usage.
From these data, researchers found divergent trends with regard to varied cardiovascular diseases. They estimated that for every 10,000 HRT users per year, there would be 25 additional heart attacks, a higher rate than originally found by the Women’s Health Initiative.
It is too early in the research process to be able to rule out other factors that may have influenced the decline of heart attacks in women. During this same time period, the American Heart Association kicked off a large national heart disease awareness campaign that could have led to earlier detection of symptoms and better treatment. However, the dietary and sedentary lifestyle patterns known to be the biggest risk factors for heart disease remained largely unchanged during this same time period.
The researchers believe that individuals weighing the risks and benefits of HRT should consider their own risk profile for heart disease (e.g. body fat composition, diet, exercise habits, etc.), and consider any changes they could make to mitigate the added risk they may face from HRT. These considerations should be discussed with a doctor before any decision regarding post-menopausal treatment options is made.
Source: Shetty, K., Vogt, W. Bhattacharya, J. 2009. Hormone replacement therapy and cardiovascular health in the U.S. Medical Care 47(5): 600-606.
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