April 7, 2007 — There is new evidence that timing of initiation of hormone therapy (HT) may determine the extent of its cardiovascular effects, this time from a new analysis of the Women's Health Initiative (WHI) randomized controlled trials. The study suggests that coronary heart disease (CHD) risk associated with hormone therapy is not significantly increased in women who take hormone therapy within 10 years of the onset of menopause, and even showed a trend toward reduced CHD risk, but that this risk increases if women start taking hormone therapy after a longer gap. Risk for stroke, however was increased at any time point postmenopause.
Lead author Jacques E. Rossouw, MD, from the National Heart, Lung, and Blood Institute in Bethesda, Maryland, emphasized to heartwire that the findings should be viewed as "reassuring" for younger women with moderate to severe menopause symptoms who have worried about the risks of starting hormone therapy. The study should not, however, be viewed as supporting any role for hormone therapy to reduce cardiovascular events.
"This analysis should be appreciated mainly for the somewhat positive message for the short-term use of hormone therapy for menopausal symptoms," he said. "For those women who were afraid to use it before, there's some encouragement here that it might be a reasonable thing to do in the short term. But it doesn't change anything about our overall recommendations, that is, you don't use hormone therapy for the prevention of heart disease at any age."
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