CV Protection With HRT + Statins May Depend on Estrogen Type
The study compared records of deaths and cardiovascular events (eg, heart attack, stroke) on some 40,000 women who took statins, of which some 3,000 women also took hormone therapy. The women were followed up for a mean of four years.
Women who took hormones with statins had a significantly lower risk of dying of any cause and moderately lower risk of dying cardiovascular disease. The rate of death from any cause was 33 per 10,000 person years in women who used hormone therapy with statins vs. 87 per 10,000 person years in women who used statins alone. The rates of death from cardiovascular disease were lower in women who used both therapies (five per 0,000 person years) than in women who used statins alone (18 per 10,000 person years); this difference was not as statistically definite.
The study findings differ with results from the Women's Health Initiative (WHI) and the Heart and Estrogen/progestin Replacement Study (HERS). Researchers believe it may be because women in Sweden used 17-beta estradiol whereas women in the WHI and HERS study used conjugated estrogens; 17-beta estradiol is a commonly found estrogen in the body before menopause. Also, statins may reduce the risk of coronary events that tend to occur early on in hormone therapy because estrogen may make plaque in the arteries unstable.
Hormone therapy combined with statins might be helpful in preventing early heart attacks and providing cardiovascular benefits later but also by preventing the onset of type 2 diabetes that statins may cause.
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