Editorial sets the record straight on the interpretation of the American Heart Association's new hormone replacement therapy guidelines

November 05, 2001

BOSTON - A groundbreaking editorial addressing the mass confusion and misinterpretation on the cardiovascular benefits of hormone replacement therapy (HRT) written by leading cardiologists, Dr. Michael E. Mendelsohn and Dr. Richard H. Karas, appears in this month's issue of Circulation: Journal of the American Heart Association. The editorial raises significant questions about the interpretation of the American Heart Association's (AHA) new guidelines and the Heart Estrogen/progestin Replacement Study (HERS) trial.

The editorial, "The Time Has Come to Stop Letting the HERS Tale Wag the Dogma," discusses the widespread impact of generalizations made by the media and medical press in response to the recent AHA guidelines on HRT and cardiovascular disease. Confusion and misinterpretation immediately followed publication of the AHA guidelines, partially because the short summary recommendations that HRT should not be initiated for the secondary prevention of cardiovascular disease, did not adequately detail the limitations and scope of HERS.

The HERS trial showed that women of a mean age of nearly 70 and who had existing cardiovascular disease may not be protected from a cardiovascular event if they were newly initiated on combined estrogen and progestin therapy. Generally, clinicians would not consider prescribing HRT to prevent cardiovascular disease for women similar to those enrolled in HERS. The HERS trail reinforces this standard practice, however, the authors believe that while HRT may not prevent cardiovascular events in women with existing heart disease, it may still protect healthy women from developing heart disease. For firm recommendations, the authors encourage physicians and women to await the results from on-going clinical trails.
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New England Medical Center is a major academic medical center that has pioneered innovative programs in clinical care, biomedical research, education and health care delivery for more than 200 years. The Medical Center offers comprehensive inpatient and outpatient services for adults and children and is the principal teaching hospital for Tufts University School of Medicine.

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