It would be true to say that for every study that claims benefits for hormone replacement therapy (HRT), there is another that says it isn’t beneficial. There are host of reasons why this might be the case and this is not really the place to have this debate – suffice it to say that the latest information from the 49th Annual Meeting of the American College of Cardiology, which was presented in March this year has stated that the claims that HRT can be beneficial to the heart may have been overstated.
A new study called ERA (Estrogen Replacement and Atheriosclerosis trial) has claimed to show that HRT does not prevent heart disease in older women. However, the study was with 309 older women who were on average 65 years old and who ALREADY had heart disease. They were each randomly given Premarin (an oestrogen only preparation), Prempro (an oestrogen and progesterone combination) or a placebo.
As the study progressed, the researchers used quantitative coronary angiography to identify and measure any changes to the participants arteries that occurred as a result of treatment. The changes that researchers were looking for included, further narrowing of the arteries and a build up of cholesterol, both of which can lead to chest pain and heart attack.
The group were followed up, on average, after 3.2 years and (perhaps unsurprisingly as all the women already had heart disease) all three groups showed the same rate of narrowing of the coronary vessels. The researchers have concluded that neither oestrogen alone nor oestrogen combined with a progesterone had positively changed the course of the existing heart disease compared to those women who had been given the placebo.
Now, I’m not one to carp on about this – but surely if you wanted to check whether heart disease was prevented by the use of hormone replacement therapy then you should perhaps have been considering working with women who didn’t display heart disease to start with!