Hormone therapy does not help prevent heart disease

In a major new study of the effects of hormone replacement therapy (HRT) on heart disease, researchers found that neither estrogen, nor estrogen combined with a progestin, slowed disease progression in 309 older women.

"This study provides additional evidence that HRT may not be as effective as we once thought in slowing heart disease," said David Herrington, M.D., MHS, of Wake Forest University Baptist Medical Center.

Herrington reported the findings at the American College of Cardiology's annual meeting. The study, used cardiac catheterization, a test that injects dye into the arteries, to measure narrowing in the heart's arteries caused by a buildup of cholesterol. As vessel disease progresses, these narrowings worsen.

A total of 309 older women with heart disease were randomly assigned to take estrogen (Premarin), estrogen combined with a progestin (Prempro), or a dummy pill (placebo). Sophisticated computer techniques were used to measure subtle changes in their arteries over the study period (an average of three years.)

"Overall, there were no differences between the groups in how quickly the disease progressed, " said Dr. Herrington, associate professor of cardiology. "HRT did lower cholesterol, but these changes didn't translate into a measurable benefit in the arteries of the heart."

This is the second major clinical study that calls into question the widely held belief that HRT is an effective treatment for heart disease. In 1998, HERS (the Heart and Estrogen/progestin Replacement Study) found that 2,763 women who took estrogen and a progestin for four years had just as many heart attacks as women who didn't take the treatment.

As a result, it was recommended that women with heart disease not begin HRT to lower their risk for future heart attacks and heart disease deaths.

"(This study) supports the findings of HERS. In both studies, there was no clear-cut evidence of benefit in women with established heart disease," said Herrington.

SOURCE: "Computerized Analysis of Heart Arteries Shows No Benefits of Hormone Therapy," Wake Forest University Baptist Medical Center, Mar. 14, 2000.