Atherosclerotic progression; Hormone therapy: a special risk for diabetic women.(News)

Postmenopausal hormone therapy is associated with greater atherosclerosis progression in women with diabetes or abnormal fasting glucose than in their counterparts with normal glucose tolerance, according to the findings of a randomized, prospective study.

The finding "provides further evidence that this regimen will not be beneficial in preventing [cardiovascular disease] in diabetic women ... who already have increased risk for atherosclerotic vascular disease," reported Barbara V. Howard, Ph.D., who is president of MedStar Research Institute, Hyattsville, Md., and her associates.

The analysis is the first to compare atherosclerotic progression in postmenopausal women with and without abnormal glucose tolerance (AGT) who are on hormone therapy (Circulation [Epub ahead of print] June 28, 2004; www.circulationaha.org).

The study was based on data from the Women's Angiographic Vitamin and Estrogen trial (JAMA 288[19]:2432-40, 2002). In that study, 321 post-menopausal women with angiographically-defined atherosclerosis were randomized to receive either hormone therapy (conjugated equine estrogen 0.625 mg/day for hysterectomized women, and the addition of 2.5 mg/day of medroxyprogesterone acetate for those with an intact uterus) or placebo for 3 years.

A total of 140 women had AGT and 181 had normal glucose tolerance (NGT), according to the investigators.

The women received follow-up angiograms near the end of the study.

Compared with placebo, hormone therapy (HT) was associated with accelerated atherosclerotic disease progression in women ...