WEDNESDAY, April 16 (HealthDay News) -- The timing of hormone
therapy might determine its effect on a woman's heart.
Specifically, researchers have found that hormone replacement
therapy (HRT) administered early in menopause to women with risk
factors for heart disease did not diminish the function of the
endothelial cells that line the inner walls of the arteries and
might even improve it. Endothelial function is a way to measure
early heart disease.
"Hormone therapy might not be as bad as was once thought," said
Dr. Suzanne Steinbaum, director of Women and Heart Disease at Lenox
Hill Hospital in New York City. "It might even be helpful in women
with risk factors."
However, there isn't enough evidence to suggest that women
should start taking HRT to lower their risk for heart disease, the
authors emphasized.
The researchers, from Virginia Commonwealth University Medical
Center in Richmond, presented their findings Wednesday at the
American Heart Association's Arteriosclerosis, Thrombosis and
Vascular Biology annual conference in Atlanta.
A section of the U.S. government-sponsored Women's Health
Initiative (WHI), which was designed to look at health issues in
postmenopausal women, was halted in 2002, when U.S. researchers
found that hormone therapy led to an increased risk of adverse
events that included heart attack, stroke, breast cancer and blood
clots. The risk depended on whether the woman was taking estrogen
alone or estrogen plus progestin, another female hormone.
Since that time, however, a more complex picture has emerged
with various factors, including amount of hormone as well as
timing, having an effect on risks and benefits of HRT.
Previous research indicated that HRT might have a negative
effect on cardiovascular health in women who started therapy long
after menopause, versus women taking it sooner after menopause.
Before the WHI, many women took HRT in the belief that it would
reduce their risk for heart disease.
For this study, researchers used ultrasound to measure
flow-mediated dilation (FMD) in the brachial artery in four groups
of postmenopausal women (127 participants total).
FMD measures how well the endothelium functions. The brachial
artery is the main artery in the arm.
"Endothelial dysfunction is often associated with risk factors,"
Steinbaum explained.
There were four groups in all: One comprised of women not on
HRT, with no heart disease risk factors and about eight years
postmenopausal; women not on HRT but who did have risk factors for
coronary disease and a little over nine years postmenopausal; women
taking estrogen alone, with risk factors and almost 12 years
postmenopausal; and women taking estrogen plus progestin and 7.6
years postmenopausal.
Most women had started HRT about the time menopause started.
Women with risk factors who took HRT saw a slight improvement in
FMD and, on the whole, there were no reductions in blood vessel
function.
More information
Visit the
Women's
Health Initiative for more on hormone replacement therapy.