Hormone therapy like HRT boosts heart disease risk
By Jimmy Downs
Sunday March 31, 2013 (foodconsumer.org) -- Some heavy weight researchers published an editorial in Annals of Internal Medicine to deliver a message that hormone therapies including hormone replacement therapy (HRT) can raise risk of heart disease.
Dr. Eliseo Guallar from Johns Hopkins Medical Institutions in Baltimore, Maryland and colleagues published the message at a time that many patients and clinicians may get confused by the results from various studies and recommendations.
The U.S. Preventive Services Task Force (USPSTF), an authoritative medical body consisting of the top experts recommends against using hormone therapy to prevent chronic diseases or conditions in postmenopausal women because a systematic review of studies published through Nov 2011 with great certainty indicates that risks from using hormone therapies outweigh the benefits when hormones are used to prevent chronic disease even through HRT may still be used to ease menopausal symptoms.
What may confuse patients and clinicians is that Danish Osteoporosis Prevention Study (DOPS) published before the releasing of the USPSTF recommendations suggests that hormone therapy when given early postmenopausal women reduced the risk for a combined end point of death, myocardial infarction or heart attack and heart failure and apparently did not increase risk for breast cancer and stroke among women who used the therapy for more than 10 years.
Many patients may have been told that hormone therapy can help prevent chronic disease like cardiovascular disease in postmenopausal women. The suggestion was largely based on some lab studies and animal studies and some trials also that indicated such a possibility.
However, the evidence suggesting a beneficial effect of estrogen or hormone therapy has been discounted after the Women's Health Initiative Study was published, which revealed that use of HRT, a type of hormone therapy, was associated with increased risk for breast cancer, coronary heart disease, stroke, and pulmonary embolism.
The editorialists say that the DOPS was not designed primarily to examine how hormone therapy could have an effect on the cardiovascular disease and they believe that the USPSTF recommendations are still "sound", which means that patients should not use hormone therapy to prevent chronic disease even though HRT may still find some application in postmenopausal women to release menopausal symptoms.
HRT has been found again associated with increased risk of breast cancer.
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