More Evidence Of Possible Adverse Effects From New Hormone Use In Women With Heart Disease

NEW ORLEANS -- Cardiologists should think twice about prescribing hormone replacement therapy for women who have heart disease, researchers at Duke University Medical Center say.

Their study, prepared for the annual meeting of the American College of Cardiology, is the second in a year that finds an association between new use of hormones in women who have previous heart disease and the occurrence of a second cardiac "event," such as a heart attack or unstable angina. This was not seen in women using such hormones before they developed heart disease.

These studies suggest the general message that hormone therapy is good for the hearts of postmenopausal women must be considered further, said Dr. Karen Alexander of the Duke Clinical Research Institute.

"While hormone use has benefits and may still be cardioprotective in women without heart disease, women who have heart disease should probably not start using them," Alexander said. "We also have no reason to suggest women stop using hormones if they develop heart disease."

In looking back at a 1996 study of the use of aspirin in heart attack patients, Alexander and her team found that more than 37 percent of women who started using hormone therapy after their attack were hospitalized for unstable angina within almost a year. That rate of hospitalization was significantly higher than for women who had never used hormones (17 percent) and those who had used them before their heart attack (21 percent).

"These data contribute to the evolving understanding of the benefits from hormone use," Alexander said.

A study reported last August was the first clue that women with heart disease should not start hormone replacement therapy (HRT), which consists of daily doses of estrogen for women who have had hysterectomies or estrogen plus the progestin hormone for women with an intact uterus.

The August study, led by the University of California at San Francis

Contact: Renee Twombly
Duke University Medical Center

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