Hormone Replacement Therapy Causes No Excess Cardiovascular Risk

A new study shows that hormone replacement therapy (HRT) in women in early menopause may have no increased cardiovascular risk from the therapy, but could even show future benefit.

Researchers of the American Association of Clinical Endocrinologists (AACE, Jacksonville, FL, USA) conducted a meta-analysis of 23 trials that compared results of HRT in women younger than 60, or less than 10 years since menopause. Studies included the Women's Health Initiative (WHI), The Heart and Estrogen-Progestin Replacement Study (HERS), and the Postmenopausal Estrogen-Progestin Interventions study (PEPI). The study results showed that when re-evaluating the studies to permit an analysis of cardiovascular disease based on age, the studies showed that after a three-year period, there was no difference in the incidence of cardiovascular disease between the HRT group and the placebo group. The study results were issued in a press release by the AACE on January 2, 2008.

"We think the data offer some reassurance to women close to the menopause, with the suggestion that estrogen supplementation may even protect against heart disease in these younger women,” said co-author Rhoda Cobin, M.D., of the Mount Sinai School of Medicine (New York, NY, USA). "And even if it is not protective, it doesn't appear to be harmful so can probably be used safely to treat menopausal symptoms. There does appear to be a window of opportunity for use of estrogen.”

"This is an important and meaningful analysis for women who can benefit from hormone replacement therapy,” said Richard Hellman, M.D., president of the AACE. "Since the WHI was published in 2002, there has been much debate over the risk to reward ratio with this treatment option. Patient safety must always be our primary objective. We can now say with good confidence that this therapy is very safe for women under 60, or who have recently experienced menopause”.

The AACE recommends that each patient be evaluated by her doctor for the severity of her symptoms, age, and specific risk factors that might impact the efficacy of HRT. Non-hormonal therapies should be offered to those women who decline hormonal therapy.


Related Links:
American Association of Clinical Endocrinologists