Fall in HRT use preventing heart attacks?

Fri April 24th, 2009

The decline in popularity of hormone replacement therapy may be linked to a fall in heart attacks, researchers said today.

Dr Kanaka Shetty and colleagues at the RAND Corporation in Santa Monica, California, USA, explain that hormone replacement therapy (HRT) was widely used until 2002, to treat menopause symptoms and because studies suggested it reduced heart disease risk.

But opposing results were published in 2002, causing HRT use to drop sharply. The researchers used this "natural experiment" to investigate links between HRT use and heart attack, stroke, and death from cardiovascular causes.

They took figures on all US women aged 40 to 79 years between 1990 and 2005, from death records, hospital discharge information and surveys of drug use.

Decreased HRT use was associated with a significant decrease in the rate of heart attacks, by about 25 cases per 10,000 person-years (that is, years of treatment with the drug). Changes in HRT use were not significantly linked to stroke. The study appears on the website of the journal Medical Care.

However, New York cardiologist Dr Nieca Goldberg believes that the drop in heart attacks may have a different explanation. "The reduction in hormone therapy coincided with the American Heart Association's and National Heart, Lung, and Blood Institute's women and heart disease awareness campaigns," she said.

"The lower rate of heart attacks may be due to better screening for heart disease risk factors in women, more woman scheduling appointments to be screened for heart disease risk factors and better awareness of women's heart attack symptoms by physicians.

"It's premature to attribute the decline in heart attack rates to the decline in hormone therapy."

Shetty, K. D., Vogt, W. B. and Bhattacharya, J. Hormone replacement therapy and cardiovascular health in the US. Medical Care, published online April 24, 2009.

Tags: Women’s Health & Gynaecology | Heart Health | North America