Hormone Replacement Therapy Losing Support

By Michael O’Reilly, M.D.

ThirdAge Women’s Health Expert

A new study confirms that women who survive a first heart attack and start hormone replacement therapy (HRT) are not protected as first thought. In fact, these women may actually be at increased risk of suffering from another heart attack.

In an approach called “secondary prevention,” doctors have prescribed HRT as a means of preventing second heart attacks. But the study, published in The Archives of Internal Medicine, has prompted the American Heart Association to re-evaluate the HRT recommendations.

The study, conducted by Dr. Susan R. Heckbert from the Group Health Cooperative at the University of Washington in Seattle, was not an ongoing comparison or controlled intervention, but rather an epidemiological study based on data from the past. The data was collected from 981 postmenopausal women, all of whom had recently suffered a first heart attack.

Throughout the three and a half years of the study, there were 186 more heart attacks. Dr. Heckbert concluded that there was “no difference in the risk of cardiac events between women who were current users of HRT and those who did not use HRT.” In fact, there was an increase in the risk of heart attack in those women in their first two months of HRT.

Though HRT ceased to be a risk after that point — and was shown to lower heart attack risk by 25 percent in patients on HRT for a year or more — the American Heart Association now recommends that “HRT not be initiated solely for its potential protective effects against cardiovascular disease.”

DR. GREENE?S COMMENT: If you are having health problems with or going through menopause then by all means use therapies that are available. But you have to have a physician who is knowledgeable about HRT and that means knowing what tests to order. How do you know which Estrogen or Progesterone therapy is right for you? You just can’t put everybody on Premarin and hope that is the correct choice. SEE: FEMALE HORMONES