Effect of hormone therapy on risk of heart disease may vary by age and years since menopause

April 03, 2007

WHAT: Secondary analyses of findings from the Women¡¦s Health Initiative (WHI) suggest that women who begin hormone therapy within 10 years of menopause may have less risk of coronary heart disease (CHD) due to hormone therapy than women farther from menopause. Overall, hormone therapy did not reduce the risk of CHD. However, the farther a woman was from the onset of menopause when she began hormone therapy, the greater her risk of CHD due to hormone therapy appeared to be. Although these findings did not meet statistical significance, they suggest that the health consequences of hormone therapy may vary by time from menopause.

These findings are consistent with the primary publications from the WHI trials of estrogen plus progestin and estrogen-alone (total of 27,347 participants) in showing no overall benefit for CHD, and in suggesting that risk due to hormones may differ depending on age or years since menopause.

"Postmenopausal Hormone Therapy and Risk of Cardiovascular Disease by Age and Years Since Menopause," will be published in the April 4 issue of the Journal of the American Medical Association.

In a secondary analysis, scientists reanalyze previously collected data and findings in an effort to clarify or ask new questions. In the case of this latest WHI analysis, the authors combined the data from the two trials to explore in more detail the previously observed trends in hormone effects by distance from the menopause. Differences in hormone therapy effects were examined in three age categories (50 to 59, 60 to 69, and 70 to 79) or in years since the onset of menopause (less than 10, 10 to 19, and 20 or more). The Women's Health Initiative and the newly published analyses are funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health.

The analyses also suggest that the increased risk in heart disease due to hormone therapy in older women is primarily in those who also have hot flashes and night sweats. Study participants who had these symptoms were more likely to have risk factors for CHD such as high blood pressure or high blood cholesterol, but it was not clear whether this explained their higher risk on hormone therapy.

Other results from the analyses of the combined trials include:WHI is a major 15-year research program designed to address the most frequent causes of death, disability and poor quality of life in postmenopausal women -- cardiovascular disease, cancer, and osteoporosis. Both the estrogen plus progestin and estrogen-alone trials of the WHI were stopped early because of increased health risks and the failure to prevent heart disease. Specifically, the estrogen plus progestin trial was stopped after 5.6 years because of an increased risk of breast cancer and because overall risks, including increased risks for heart attack, stroke, and blood clots, outnumbered benefits. The estrogen-alone study was stopped after 6.8 years because of an increased risk of stroke and no reduction in risk of CHD. The estrogen-alone study also found an increased risk of blood clots.

WHO: Jacques Rossouw, M.D. chief of the Women's Health Initiative Branch at NHLBI, and lead author of the study, is available to comment on the implications of the new study for women considering hormone therapy at different ages. He will note that the findings may be somewhat reassuring to younger women considering hormone therapy for short term relief of symptoms, but do not change the current recommendation that hormone therapy should not be used at any age for prevention of CHD. Women considering hormone therapy should have risk factors such as blood pressure and blood cholesterol measured and managed, and have regular mammograms. Dr. Rossouw can comment on the need for additional research to explore the overall findings and the finding regarding night sweats and hot flashes.
-end-
Embargoed for Release
Tuesday April 3, 2007
4:00 p.m. Eastern

Contact: NHLBI Communications Office
(301) 496-4236
E-mail: nhlbi_news@nhlbi.nih.gov

CONTACT: To schedule interviews with Dr. Rossouw, contact the NHLBI Communications Office at 301-496-4236 or e-mail nhlbi_news@nhlbi.nih.gov

Part of the National Institutes of Health, the National Heart, Lung, and Blood Institute (NHLBI) plans, conducts, and supports research related to the causes, prevention, diagnosis, and treatment of heart, blood vessel, lung, and blood diseases; and sleep disorders. The Institute also administers national health education campaigns on women and heart disease, healthy weight for children, and other topics. NHLBI press releases and other materials are available online at: www.nhlbi.nih.gov.

The National Institutes of Health (NIH) -- The Nation's Medical Research Agency -- includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

NIH/National Heart, Lung and Blood Institute

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.