Study raises questions about HRT in diabetic women.(hormone replacement therapy)

2003 JAN 2 - (NewsRx.com & NewsRx.net) -- In a large observational study of hormone replacement therapy (HRT) in women with diabetes, researchers have found that the effects of HRT may depend on whether a woman has had a prior heart attack.

In diabetic women who hadn't experienced a recent heart attack, HRT was associated with a 16% lower risk of heart attack.

"Our results are inconsistent with the results from the Women's Health Initiative (WHI), a randomized trial in women without heart disease, which reported a 30% increased risk of heart disease in women taking HRT compared with women on placebo," said lead author Assiamira Ferrara, MD, PhD, in the division of research at the Kaiser Foundation Research Institute in Oakland, California, whose findings were published in the December 2, 2002, online version of Circulation.

"Dr. Ferrara's research adds to the pool of literature regarding the cardiovascular effects of HRT in postmenopausal women, but observational studies such as this, as opposed to prospective clinical trials like WHI, are not definitive and often raise more questions than they answer," said American Heart Association President Robert Bonow, MD. "And this study does raise an important question about HRT in diabetic women - a question that can only be answered by a randomized clinical trial."

In July 2002, the Women's Health Initiative trial was stopped when the study demonstrated no benefit, and possibly an increased risk of heart attacks and strokes in women taking combined HRT (estrogen plus progestin).

"WHI is an important study that demonstrates the value of large, randomized trials to guide clinical decisions and to advise the public," said Bonow in a statement responding to the findings from WHI.

Ferrara and colleagues followed 24,420 women (average age 65) with no history of recent heart attack (within the past year), and 580 women (average age 69) with a recent heart attack.