Hormone therapy offers no protection against heart attacks.(Brief Article)

2002 AUG 1 - (NewsRx.com & NewsRx.net) -- Postmenopausal women with coronary heart disease (CHD) should not take estrogen plus progestin hormone therapy to reduce their risk of CHD events, such as a nonfatal heart attack or death from coronary disease, according to an article in the July 3, 2002, issue of the Journal of the American Medical Association. In an accompanying report, long-term hormone therapy increased the risk for venous thromboembolism (blood clots) and gallbladder disease.

Deborah Grady, MD, MPH, of the University of California, San Francisco, and colleagues investigated whether the trend toward reduced risk of CHD events among women who were taking hormone therapy in the later years of the Heart and Estrogen/progestin Replacement Study (HERS) persisted with additional years of follow-up and resulted in an overall reduced risk of CHD events. Grady et al. followed a group of participants in HERS (which lasted 4.1 years) for an additional 2.7 years for their study, HERS II.

HERS was a randomized, blinded, placebo-controlled trial of 2763 postmenopausal women, average age 67 at enrollment, with CHD. Women were randomly assigned to receive either 0.625 mg/d conjugated estrogen plus 2.5 mg medroxyprogesterone acetate (n=1380) or placebo (n=1383).

The 1998 report on the HERS study found "no significant differences between the hormone and placebo groups in the primary outcome of CHD events (nonfatal myocardial infarction [MI] plus CHD-related death) or in any secondary cardiovascular outcomes. However, ...analyses showed a statistically significant time trend, with more CHD events in the hormone group than in the placebo group during the first year of treatment, and fewer in years 3 to 5."

The researchers enrolled 2321 women for HERS II, 93% of the surviving HERS participants. The women were prescribed hormone therapy at the discretion of their physicians after HERS ended and their study group - hormone or placebo - was unblinded. Many women in the hormone group decided to take hormones during HERS-II, and fewer of those in the placebo group did.

The authors found that "after 6.8 years [HERS plus HERS II], hormone therapy did not reduce risk of cardiovascular events in women with CHD." There were 290 CHD events (heart attacks and coronary deaths) in the hormone therapy group, and 293 in the placebo group. "Our findings lend additional support ...