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The Effect of Estrogen Plus Progestin on Coronary Heart Disease. Annals of Internal Medicine. 2010 Feb;152(4):I-40.

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Summaries for Patients | 16 February 2010

The Effect of Estrogen Plus Progestin on Coronary Heart Disease FREE

The summary below is from the full report titled “Coronary Heart Disease in Postmenopausal Recipients of Estrogen Plus Progestin Therapy: Does the Increased Risk Ever Disappear? A Randomized Trial.” It is in the 16 February 2010 issue of Annals of Internal Medicine (volume 152, pages 211-217). The authors are S. Toh, S. Hernández-Díaz, R. Logan, J.E. Rossouw, and M.A. Hernán.

Ann Intern Med. 2010;152(4):I-40. doi:10.7326/0003-4819-152-4-201002160-00002

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What is the problem and what is known about it so far?

Women who receive hormone therapy after menopause have an increased risk for heart attacks and other problems related to the arteries in their hearts. Some persons, however, believe that there may not be an increased risk when women start hormone therapy soon after menopause.

Why did the researchers do this particular study?

One study of a large number of nurse-participants who decided whether to take or not take hormone therapy after menopause found a possible increased risk in the first 3 years of use in women who started hormone therapy within 10 years after menopause, but this study could not rule out the possibility that something other than hormone therapy caused the increased risk.

Who was studied?

16 608 postmenopausal women aged 50 to 79 years who had an intact uterus when the study started.

How was the study done?

Women were randomly assigned to receive either combined hormone therapy (estrogen plus progestin) or a placebo.

What did the researchers find?

A possible increased risk was present in the first 2 years in women who started hormone therapy within 10 years after menopause, and increased risk persisted until about 6 years after use.

What were the limitations of the study?

The results could have occurred by chance, but this information is, and will probably be for a long time, the best available evidence on this topic.

What are the implications of the study?

Most women use combined hormone therapy to treat the symptoms of menopause, which means they start hormone therapy soon after menopause and generally use it for less than 6 years. These women should not expect hormone therapy to protect them from heart attacks, and they may need to worry about a possible slightly increased risk for heart attacks.

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