HRT confirmed to increase heart attack risk in women

Tuesday May 13, 2009 (foodconsumer.org) -- In 2002, the Women’s Health Initiative made the announcement that hormone replacement therapy (HRT) might put women at greater risk for heart attack.

The response to the announcement was profound. In the mid 1990s to 2001, 30% of women aged 50-59 were on HRT; at this point, less than 15% take estrogen.

Unwittingly, the furor set in motion by the initial WHI announcement provided researchers an informal “study,” of sorts. It turns out that the WHI was spot on. There has been a marked decrease in the number of heart attacks since 2002; according to the RAND Corporation, the decrease translates into 25 fewer heart attacks per 10,000 persons/year.

Dr. Nieca Goldberg, cardiologist at Total Heart Care in NYC, says it’s premature to assume that the decrease of myocardial infarction over the last 7 years is entirely due to HRT being taken out of the equation. At the same time that WHI made their proclamation regarding heart attack and HRT, the American Heart Association launched its “Women and Heart Disease Program,” a nationwide effort to educate the public about the risks of heart attack in women.

Prior to 2001, doctors assumed that HRT might actually lower the risk of heart attack in women; estrogen lowers bad cholesterol while simultaneously increasing good cholesterol in a woman’s blood stream. While seemingly counterintuitive, the positive affects HRT has on cholesterol is irrelevant, with regards to heart attack risk.

According to the New York Times, the WHI began to study the risks of HRT on women’s health back in 1993, focusing on an increased risk for heart attack, stroke, and certain forms of female cancer.

In 2002, the study of women who took estrogen-progestin supplements was stopped because of a correlation between HRT and breast cancer. In 2004, the WHI’s study that focused on estrogen-only supplementation was stopped because of an increased incidence of stroke. In both instances, the risks of HRT were determined to negate the potential benefits.

While long term HRT is not recommended, there seems to be no health risk to those using HRT as a stop gap to ease menopausal symptoms on a temporary basis (2-4 years).

(By Rachel Stockton, and edited by Heather Kelley)