October 30, 2008
Danish study finds HRT does not raise heart attack
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 on Tuesday.
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 a large study called 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. Sales of all HRT drugs plummeted.
But some experts suggested the study gave a very limited picture of HRT and said perhaps different drugs, taken by women at younger ages, 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.
"Overall, we found no increased risk of MI (heart attack) with the current hormone therapy compared with women who never used hormone therapy," they wrote in their report.
Younger 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. This is the way Prempro was dosed.
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.
Patches or gels lowered the risk of heart attack by between 38 percent to 44 percent.
The type or dose of estrogen or progesterone did not matter, they found. Women are currently advised to take the lowest dose of HRT possible for the shortest possible time.
"Our study does not change indications and duration recommendations for HRT," Lokkegaard said.
"But the main message is that when hormone therapy is indicated for a woman, then a cyclic combined regimen should be preferred, and that application via the skin or the vagina is associated with a decreased risk" of heart attack.
She said she believed HRT taken this was also lowers the risk of breast cancer, blood clots and stroke.
Source: Reuters
Reported by: Maggie Fox
Source: http://www.reuters.com/
Comments:
A 15 year research study conducted by Women's Health Initiative study was abruptly stopped in 2002, with lot of media attention, because of the finding that the combination estrogen and progesterone replacement therapy considerably increased the risk of developing breast cancer. Older women in the study were at higher risk for heart attacks if they began using hormones. It was also estimated that after stopping the hormone therapy, the heightened risk of heart attack, blood clots, and stroke quickly dropped to the levels similar to women who had not taken the therapy. Women’s Health Initiative study was a combination of a set of planned clinical trials as well as observational studies. Now six years later this new Danish study, with nearly 700,000 women, showed that hormone replacement therapy not only, does not increase the risk of heart disease, but taking the these hormones in a different way can in fact lower the risk of heart attack, regardless of the type of estrogen or progesterone! However the current study is mere observation of the facts and does not intervene. As some experts suggested it just gives a limited picture because other factors like drugs, supplements, diet, exercises are not well matched to jump to a wide spread conclusion. It is outrageous to see that after the failure of the huge clinical trial in 2002, some of the researchers still want to believe that hormone replacement could be beneficial in some form and recommend continuing prescribing them. Very recently HRT was also reported to cut the risk of breast cancer in some! Clearly there is vast corporate interest in bringing up the sales of HRT medications that would push such studies to be published with media hype. Menopause is a normal physiological change in a woman's lifecycle and it is now portrayed as a disease, which needs treatment, earning billions of dollars for the makers of such "treatments." In addition, industry affiliates try to confuse the population by publishing such opposing studies in a desperate attempt to regain the revenues and reputation.
For more than a decade, Dr. Rath has been fighting against such unethical pharmaceutical practices. Please join Dr. Rath's fight against the pharmaceutical cartel by reading more in his book “Road Map to Health”.
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