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Main Category: Menopause
Also Included In: Women's Health / Gynecology
Article Date: 10 Oct 2012 - 3:00 PDT
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10 Years HRT Reduces Heart Attack And Heart Failure Risk Dramatically
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Women who receive Hormone Replacement Therapy (HRT) soon after the menopause have a much lower risk of heart attack, heart failure or dying early compared to women of the same age who do not, Danish researchers reported in the BMJ.
HRT has been a controversial subject for a number of years. There are frequent discussions and arguments regarding the advantages of HRT and its negative consequence, namely breast cancer risk.
A report published in the Journal of Family Planning and Reproductive Healthcare in January 2012 wondered how reliable the Million Women Study which linked HRT to breast cancer risk really was.
Conflicting findings from various studies have led doctors to believe that the timing after menopause is what matters when recommending HRT to their patients. The belief being that cardiovascular outcomes are influenced by how long after menopause HRT can begin.
A team of researchers from Denmark carried out a 10-year long randomized trial, with an extra six years of follow-up to determine what impact HRT might have on cardiovascular risk if it were started soon after menopause.
They recruited 1,006 women and randomly selected them into two groups:
- The HRT group - 504 women
- The non-HRT group - 502 women
The researchers used information on diagnoses or death from the Danish Civil Registration System and National Hospital Discharge Register. The primary end-point was a combo of death and hospitalization for heart failure or a heart attack.
After a decade of randomized treatment, the patients were advised to stop HRT after the results of the Women's Health Initiative and the Million Women Study were published.
During this ten year period:
- In the HRT Group - there were 15 deaths and 16 deaths or cardiovascular end-points
- In the non-HRT Group - there were 26 deaths and 33 deaths or cardiovascular end-points
- 33 women in the HRT group - 27 deaths, 3 heart failures, and 3 heart attacks
Causes of death - 6 cardiovascular deaths and 21 non-cardiovascular deaths - 53 women in the non-HRT group - 40 deaths, 8 heart failures, and 5 heart attacks
Causes of death - 23 cardiovascular deaths and 17 non-cardiovascular deaths
The researchers concluded:
"After 10 years of randomized treatment, women receiving hormone replacement therapy early after menopause had a significantly reduced risk of mortality, heart failure, or myocardial infarction, without any apparent increase in risk of cancer, venous thromboembolism, or stroke."
What is HRT (Hormonal Replacement Therapy)?
Hormone Replacement Therapy, often referred to as HRT is given to women after the menopause when their estrogen and progesterone levels fall significantly. Progesterone and estrogen are hormones. HRT raises the levels of these hormones.As the menopause approaches, estrogen and progesterone levels drop. Some women have HRT to reduce certain menopausal symptoms.
Estrogen stimulates the release of eggs. When a woman's egg supply has ended, estrogen levels start to drop. Estrogen helps maintain healthy bones (good bone density), as well as skin temperature; it also regulates moisture in the vagina. When estrogen levels fall, the following symptoms are possible:
- Fat build-up in the abdomen
- Smaller breasts
- Concentration and memory difficulties
- Hot flashes (UK: hot flushes)
- Irregular periods
- Lower fertility
- Moodiness
- Night sweats
- Sleep problems
- Thinning hair
- Urinary problems
- Vaginal dryness
Progesterone prepares the uterus for possible pregnancies. When levels drop, women do not usually experience any immediate discomfort.
Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
Louise Lind Schierbeck, Lars Rejnmark, Charlotte Landbo Tofteng, Lis Stilgren, Pia Eiken, Leif Mosekilde, Lars Køber, and Jens-Erik Beck Jensen
BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e6409 (Published 9 October 2012)
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