Study finds HRT does not increase heart attack risk

WASHINGTON - Women who take hormone replacement therapy to treat menopause symptoms do not have a higher than usual risk of heart attack, especially if they use a cream or skin patch or take cyclic hormone combinations, Danish researchers reported yesterday.

Their study, published in the European Heart Journal, suggests it is not hormone replacement therapy that raises the risk of heart attacks in women, but the way it is taken.

It also shows that the Women's Health Initiative, which frightened many women away from HRT after it was stopped in 2002, may not be the last word on treatment.

"This study is the first big observational study that addresses the influence of various regimens, doses, and routes of administration," Dr. Ellen Lokkegaard of the Rigshospitalet in Copenhagen, who led the study, said in a statement.

The Women's Health Initiative was stopped in early 2002 because HRT combining estrogen and progestin appeared to cause a 24 percent higher risk of breast cancer. Women taking the combination of hormones had twice the normal rate of blood clots, and higher risks of stroke and heart attack. Most of the women took Premarin or Prempro, made by Wyeth.

But some specialists suggested the study gave a very limited picture of HRT and said that perhaps different drugs might have other effects.

Lokkegaard's team studied 698,000 women aged 51 to 69 in Denmark, who take part in a national health database.

Women aged 51 to 54 had a 24 percent higher risk of heart attack than women who had never taken HRT - but the risk in this age group is low to start with.

Women who took continuous HRT - when estrogen and progesterone are taken together every day - had a 35 percent higher risk of heart attack compared with women who had never used HRT.

But if HRT was taken on a cyclical basis - with estrogen pills for 25 days, adding progestin for the second half of the month and then taking no pills for three to five days - women had a lower risk of heart attack.