Previous observational studies have suggested that HRT could reduce the risk of coronary heart disease (CHD), but results of randomised trials do not suggest a lower risk in women who use combination oestrogen/progestagen therapy. A team of scientists from the University of Manchester, UK, assessed whether or not oestrogen reduced the risk of further cardiac events in postmenopausal women who survived a first heart attack.

Around 1000 postmenopausal women, age 50-69 years who had survived a first heart attack were recruited from 35 hospitals in England and Wales. They were given either one daily tablet of 2 mg oestradiol valerate or placebo for two years. There was no difference in the frequency of recurrent heart attack or cardiac death at follow-up, and the difference in all-cause mortality (lower among women given oestrogen therapy) was not statistically significant.

Nicola Cherry, the principal investigator, comments: "Oestrogen therapy does not reduce the overall risk of further cardiac events in postmenopausal women who have survived aheart attack. This study provides insufficient evidence of benefit to alter current guidance against the use of HRT for the secondary prevention of cardiovascular disease."

See also Commentary - 'Hormones for coronary disease-full circle'.

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Contact: Richard Lane
richard.lane@lancet.com
44-20-7424-4949
Lancet
16-Dec-2002