Wednesday, June 20, 2007

Arteries clearer in younger menopausal women taking estrogen

Younger menopausal women who took estrogen reduced their risk of developing coronary artery calcium, a predictor of heart disease, by 40 percent, a study from the Women’s Health Initiative found.

Dr. JoAnn E. Manson, chief of preventive medicine at Brigham and Women’s Hospital, and colleagues report in tomorrow’s New England Journal of Medicine an even higher risk reduction of 60 percent in the women aged 50 to 59 years old who regularly took estrogen over an average of 7.4 years, compared with those who regularly took a placebo in the randomized clinical trial of more than 1,000 women.

"The findings provide additional reassurance for recently menopausal women who are considering hormone therapy for the short-term treatment of hot flashes, night sweats and other symptoms that disrupt quality of life," Manson said in an interview. "We do caution that this should not be interpreted to mean estrogen should be taken for the express purpose of preventing cardiovascular disease. There are risks."

The risks of taking estrogen pills for more than four to five years include blood clots that can travel to the lungs, and an increased risk of stroke and breast cancer, Manson said.

Women who are more than a decade past menopause did not benefit from taking estrogen, previous studies have shown. Dr. Michael E Mendelsohn and Dr. Richard H. Karas of Tufts University School of Medicine say in an accompanying editorial that the "timing hypothesis" of estrogen therapy may explain why the larger WHI trial showed that hormone therapy did not cut the incidence of heart disease. Older women who already have hardening of the arteries don’t benefit from estrogen.

Younger women struggling to decide whether to start hormone therapy to ease menopausal symptoms should consider taking estrogen in the lowest doses for the shortest possible time, Manson said.

"The pendulum has swung from one extreme to the other," she said. "We now have a more refined understanding of the benefits and risks of hormone therapy and how age and time since menopause influence heart health outcomes."

Posted by Elizabeth Cooney at 05:20 PM

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