Study shows HRT has mixed effects on quality of life: Experts warn data may not apply to those without heart disease or younger women. (Postmenopausal Women with Heart Disease).

The finding that hormone replacement therapy is associated with a decline in quality of life in some postmenopausal women with preexisting heart disease should not be applied to other populations, experts caution.

In a new analysis of data from the Heart and Estrogen/Progestin Replacement Study (HERS), postinenopausal women who were having hot flashes at study entry were most likely to see a benefit in quality of life, but those who weren't flushing actually experienced a decline.

The results of the randomized, double-blind, placebo-controlled study, which included only postmenopausal women with preexisting heart disease, do not necessarily apply to younger women or those without heart disease, study investigators said.

"The participants in this study do not represent the majority of menopausal women," Dr. Victoria Kusiak, a spokesperson for Wyeth-Ayerst, the pharmaceutical company that sponsored the HERS trial, agreed in an interview. "Other studies of younger, healthy menopausal women do demonstrate that HRT [hormone replacement therapy] brings a general improvement in quality of life."

She added that a large, randomized comparison of HRT versus placebo in healthy menopausal women still needs to be done.

The HERS study randomized 2,763 postmenopausal women (mean age 67 years) with documented coronary artery disease to receive either 0.625 mg/day of conjugated equine estrogen plus 2.5 mg / day of medroxyprogesterone acetate or placebo for 36 months.

Earlier findings from the HERS study sent shock waves through the medical community. Not only was the study hypothesis that HRT would protect against coronary events proved false, but women who were randomized to receive HRT actually had a higher cardiovascular event rate in the first year than did women on placebo.