Heart protection and routes of HRT
8 June 2020
It is now well established that use of HRT within 10 years of the menopause, or under the age of 60, reduces the risk of heart disease.
Debate continues around whether or not different types and routes provide different levels of protection.
The KEEPS trial:
A randomised trial of the effects of oral estrogen (Conjugated Equine Estrogen-CEE) or transdermal estradiol patch, compared with placebo, assessed the effects on heart fat accumulation and progression of atherosclerosis in recently menopausal women.
In a recent publication from the KEEPS trial, 467 women were allocated to one of the HRT regimens or placebo and followed for 48 months.
- It appeared that oral CEE was more likely to slow down the adverse effect of heart fat accumulation than transdermal estrogen on progression of atherosclerosis.
- It is unclear whether this beneficial effect is due to the oral route rather than the type of oral estrogen.
- It is also unclear whether this translates to differences in reduction of cardiovascular disease.
For the moment, the main influencing factors which determine which route each woman uses include:
- personal preferences
- response to treatment
- presence or not of side effects
- medical history.
Ongoing research is still needed to further clarify effects of different types and routes.
See more information about routes of HRT at route
Reference: Heart fat and carotid artery atherosclerosis progression in recently menopausal women: impact of menopausal hormone therapy: The KEEPS trial.
El Khoudary SR, Venugopal V, Manson JE
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