HRT use falls among women with heart disease risk

By April Clarkson, June 20th, 2013 | Health | 0 Comments

Hormone replacement therapy (HRT) was once believed to reduce the risk of heart disease among post-menopausal women. Rates of heart disease are lower before the menopause, suggesting a protective role of the hormone estrogen. Since estrogen levels fall sharply during and after menopause HRT, which supplies estrogen, ought to help prevent heart disease. However, studies have shown this is not so and, indeed, certain forms of HRT actually increase the risk of heart attack and stroke.

So how has this about-turn affected HRT prescribing and use? A team at Columbia Presbyterian Medical Center set out to address this question, using data from the US National Health and Nutrition Examination Surveys. In the first time period, 26% of US women were taking HRT. But four years later, use of HRT had gone down to 14%. The biggest decline was among those with two or more heart disease risk factors where HRT use went down by 19%. By contrast, HRT use was down by only 3% among those who had fewer than two heart disease risk factors.

The researchers conclude that it is pleasing that physicians and patients have got the message about HRT. It does not protect the heart and may even harm your health. But they do wonder why there are still a substantial proportion of women taking HRT even those they are high risk for heart disease. Either they are not aware of the risk or they need the HRT for severe menopausal symptoms. Women considering HRT should weigh up the potential risks and benefits for them with their physician before taking it.