HRT & Heart
HRT GOOD FOR HEART AUG. 20007
New WHI data on younger women is more reassuring
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A recent study finds that estrogen takers between the ages of 50 and 59 have less calcified plaquee in their coronary arteries and a lower prevalence of subclinical coronary artery disease than estrogen abstainers.
In an ancillary substudy of the Women’s Health Initiative Trial, women between the ages of 50 and 59 who had already undergone hysterectomy received either 0.625 mg/day conjugated equine estrogens or placebo and were followed with computed tomography of the heart for up to 8.5 years.
The mean coronary-artery calcium score at the end of the trial was about one third lower in the group of women taking estrogen than in the group taking placebo (83.1 vs. 123.1, respectively;P=0.02). In fact, the estrogen group had both a lower prevalence and a lower quantity of coronary-artery calcium than the women in the placebo group. Their odds ratios for high levels of coronary-artery calcium were generally 30% to 40% lower in intention-to-treat analyses and up to 60% lower in women with at least 80% adherence to the study protocol for at least 5 years.
The investigators point out that while coronary-artery calcification correlates closely with the degree of underlying atherosclerosis and the risk of future cardiovascular events, HT may still influence the risk of heart disease by other mechanisms. Nevertheless, they concluded “women 50 to 59 when they were randomly assigned to receive conjugated equine estrogens had . . . a lower prevalence of subclinical coronary artery disease after completion of the WHI trial than women receiving placebo.”
Manson JE, Allison MA, Rossouw JE, et al. Estrogen therapy and coronary-artery calcification. N Engl J Med. 2007;356:2591-2602.