New Study Answers Some Questions About HRT and Cardiovascular Disease Risk
the MPR take:
Questions about the use of hormone replacement therapy (HRT) in menopausal women and its effects on cardiovascular disease (CVD) progression led researchers to conduct a 4-year study to assess atherosclerosis progression and risk factors for CVD in healthy recently menopausal women given HRT. Study results were published in the journal Annals of Internal Medicine. In order to be included in the study, the women had to meet the following criteria: last menses occurred 6-36 months prior; coronary arterial calcium (CAC) score <50 Agatston units; and no estrogen or lipid-lowering treatments for at least 90 days. 727 women were then given either oral conjugated equine estrogens 0.45mg/d or transdermal 17β-estradiol 50mcg/day; in addition, the women were also given oral progesterone 200mg for 12days/month or placebo. Annual change in carotid artery intima-media thickness (CIMT) was the primary endpoint, while changes in markers of cardiovascular disease risk was a secondary endpoint. Study results showed that increases in CAC score did not differ significantly across the groups; mean CIMT increases of 0.007mm/y were also similar across the groups. Women in the oral conjugated equine estrogens group showed improvement in LDL and HDL cholesterol levels; C-reactive protein and sex hormone-binding globulin also increased in this group. In the transdermal group, insulin resistance decreased. No changes in blood pressure were seen in either group. Researchers concluded that early HRT in menopausal women did not affect atherosclerosis progression; however, since the study was only 4 years long, more research will need to be done to see what the possible long-term effects may be.
BACKGROUND: Whether menopausal hormone therapy (MHT) protects against cardiovascular disease (CVD) remains unclear. OBJECTIVE: To assess atherosclerosis progression and CVD risk factors after MHT initiated in early menopause. DESIGN: Randomized, controlled trial. (ClinicalTrials.gov: NCT00154180). SETTING: Nine U.S. academic centers....