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Hormone Therapy Not Risky for Heart Disease in First Year: Presented at ACOG

By Bruce Sylvester

NEW ORLEANS, LA -- May 5, 2003 -- Retrospective analysis of four large trials indicates that estrogen therapy is not associated with increased risk of coronary heart disease within the first year of treatment, researchers report.

These results were presented on April 30^th in a poster presentation at the 51^st Annual Meeting of the American College of Obstetricians and Gynecologists.

"This data will speak to, among others, clinicians who use hormone therapy to treat the symptoms of menopause in healthy, early postmenopausal women, clinicians who have become concerned about the risks of cardiovascular events," said lead investigator and presenter Rogerio Lobo, MD, professor of obstetrics and gynecology, Columbia University College of Physicians, in New York.

Cardiovascular events in the four trials were noted for the 652 placebo subjects and the 6,681 women using a variety of hormone therapies, including conjugated equine estrogens, conjugated equine estrogens plus medroxyprogesterone acetate, conjugated equine estrogens with trimegestone, 17-beta estradiol with trimegestone, or 17-beta estradiol with norethisterone acetate. The original, common purpose of each trial was to calculate the vasomotor relief and endometrial safety associated with hormone therapy.

During the first year of therapy in all cohorts, no cardiovascular-related deaths occurred. One subject in the active treatment groups had a myocardial infarction (equals an annual rate of.17 per 1000 patient years). Two women in the placebo group had myocardial infarctions (equals 3.7 events per 1000 patient years).

The expected annualised rate of myocardial infarctions among the general population of women ages 50 to 59 years is 1.4 per 1000 women.

The annualised rate in the study for stroke was.87 per 1000 patient years among women on active agents and 0 for placebo (expected rate for general population in this age-group is 0.8)

Deep vein thrombosis occurred among the actively treated women at a rate of 1.04 per 1000 patient years, with an expected rate of 0.76 or greater. No deep vein thrombosis was reported among placebo subjects.

"These findings would suggest that the results of early coronary heart disease risk observed in Women's Health Initiative [trial] might not be applicable to healthy, younger postmenopausal women who seek treatment for menopausal symptoms," the authors concluded. "The possible increase in deep-vein thrombosis with hormone therapy is consistent with previous data."


[Study title: Evaluation of Cardiovascular Event Rates with Hormone Therapy in Healthy Postmenopausal Women. Poster: 7.]

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