Hormone replacement therapy and heart disease

Contrary to what many women have been told, a new study published in the New England Journal of Medicine (August 24, 2000; 343:522-529, 530-537) reveals that hormone replacement therapy (HRT) does not protect against heart disease.

Researchers studied the effects of two forms of HRT on women with existing coronary artery disease. The two forms of HRT studied were horse-derived estrogen (found in Premarin) and the same estrogen plus synthetic progesterone (progestin). At the end of the 3.2-year study, researchers observed that neither treatment had altered the progression of the disease.

The authors concluded that women with established disease “should not use estrogen replacement with an expectation of cardiovascular benefit.” An accompanying editorial states:

“Evidence is mounting that current postmenopausal hormone preparations may not be effective as secondary prevention for some women. For example, the Heart and Estrogen/Progestin Replacement Study (HERS) (7) found that 4.1 years of treatment with conjugated estrogen plus medroxyprogesterone acetate had no overall effect on the rate of nonfatal myocardial infarction or death among women with established coronary artery disease. However, an increased risk of cardiovascular events was associated with the study regimen in the first year.”

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