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HRT good for heart after all!

15 February 2006

The debate around the use of HRT and risk of cardiovascular disease continues!
A statement from the International Menopause Society released this week emphasises
the apparent beneficial effect of HRT on reducing risk of coronary events if
started early enough. A detailed analysis of the oestrogen alone arm of the
WHI trial showed that the slight increase in coronary events (not statistically
significant) only occurred in women older than 70 years at the commencement
of the study and in those who were more than 20 years postmenopausal. In younger
women, there were less coronary events in the HRT users. The combined arm of
the trial also showed a possible beneficial effect of HRT users in younger
women. Further, a recent report from the Nurses? Health Study has demonstrated
a significantly reduced risk of coronary heart disease in women who started
HRT near the menopause. For full statement: click here: www.imsociety.org (pdf
file)


Another report on risk of heart attack (myocardial infarction) and hormone
replacement published in Maturitas this month, described the findings of a
population based study using the UK General Practice Research Database. The
results showed that use of postmenopausal HRT is associated with a decrease
in risk of acute myocardial infarction compared to non-users. The benefit did
not differ between different regimens of HRT. [Ref 30]


Although HRT is unlikely to provide benefit to women who
already have arterial disease, it appears increasingly likely that use of HRT
in the early menopausal years can reduce the risk of heart attacks while providing
good control of menopausal symptoms. It should therefore continue to be used
with confidence.


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