Women taking hormone replacement therapy, or HRT, to treat menopause symptoms are not at an increased risk of heart attack, especially if using cream, skin patch or taking “cyclic” hormone combinations, reports Danish researchers.
The study, published in the European Heart Journal, suggests hormone replacement therapy does not raise the risk of heart attack in women, but rather how and when it is administered.
“This observational study is the biggest of its kind, to assess the influence of various types of therapies, doses and routes of administration,” Dr. Ellen Lokkegaard of the Rigshospitalet in Cophenhagen, lead author of the study.
The Women’s Health Initiative (WHI), sponsored by the U.S. government was designed to examine health issues in postmenopausal women. In 2002, it was discontinued after researchers found that HRT increased the risk of adverse events including blood clots, heart attack and breast cancer.
The risk was based on whether the woman was taking estrogen independently or with progesterone, another female hormone.
For this study, researchers looked at 698,000 women between the ages of 51 to 69 in Denmark, for six years.
There was no greater risk of heart attack in women using HRT, compared to women never having used hormone therapy. There was, however, a 24 percent raised risk in women between the ages of 51 to 54 and a heightened risk in younger women taking the prescribed medication for a longer duration of time.
Women taking continuous HRT – estrogen and progesterone together everyday – had 35 percent greater risk of heart attack compared to those women who had never used HRT.
However, HRT taken on a cyclical basis – estrogen pills taken for 25 days, then adding progestin during the second part of the month and no pills for three to five days – showed a lower risk of heart attack.
Gels and patches lowered the risk of heart attack by 38 to 44 percent.
Researchers found, the type and dosage of estrogen and progesterone did not matter. Currently, women are advised to take the lowest dosage of HRT for the shortest time possible.
“Our study does not change current indications and recommendations for HRT,” wrote Lokkegaard.
“While the data is interesting, it is in no way definitive," said Dr. Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital/Columbia University Medical Center. #