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Low-Dose Estrogen Linked to Lower Heart Disease Risk.
Experts say estrogen's benefits outweigh increase in stroke risk with normal dose.
Postmenopausal women on low-dose estrogen have a decreased risk of developing major coronary heart disease, compared with those who never used hormones, according to the latest results of the Nurses' Health Study.
These findings are in line with earlier results of the ongoing study of more than 70,000 women. In past reports from this study, current estrogen users with no history of cardiovascular disease have had an overall 40% lower risk of developing the disease, compared with women who have never used estrogen.
The most recent analysis considered the cardiovascular effects of various estrogen doses. A total of 768 cases of major coronary heart disease, defined as either nonfatal myocardial infarction or coronary death, were reported. Coronary disease risk decreased with both the standard daily dose of 0.625 mg (relative risk, 0.54) and a low dose of 0.3 mg (relative risk, 0.58), either alone or in combination with a progestin. The relative risk for high-dose estrogen (greater than or equal to 1.25 mg/day) was 0.7 (Ann. Intern. Med. 133[12]:933-41, 2000).
As in previous analyses of the study, there was a strong dose-response relationship between estrogen and stroke risk, said Francine Grodstein, Sc.D., of Channing Laboratory, Boston, and her associates.
A total of 767 strokes were reported. Stroke risk was significantly increased among women whose daily estrogen dose was 0.625 mg (relative risk, 1.35) or at least 1.25 mg (relative risk, 1.63), compared with never-users. Women who took 0.3 mg of estrogen per day had a lower risk of stroke (relative risk, 0.54), but this decrease was not statistically significant.
The findings, based on 20 years of follow-up, were adjusted for factors such as age, body mass index, and hypertension.
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