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Does Hormone Replacement Therapy Reduce or CAUSE Heart Disease?

Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women.

Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B, Vittinghoff E.
University of California, San Francisco.
Heart and Estrogen/progestin Replacement Study (HERS) Research Group.
JAMA 1998 Aug 19;280(7):605-613

A four-year study following 2,763 post menopausal women ranging in age from 44 to 79 years, found that women taking a PremProTM (Eestrogen + Progestin) had a 50% higher risk of a heart attack during their first year on the pills than those women on the placebo and over the entire length of the study suffered the same number of deaths and heart attacks as those who took the placebo.

This report is very important, because doctors have been telling women for years that Hormone Replacement Therapy after menopause would reduce their risk of osteoporosis, heart disease and cancer. The potential benefit of Hormone Replacement Therapy was merely a hypothesis based on observations and had never been confirmed in clinical trials. This study also showed that more women in the hormone group (HG) experienced life threatening blood clots than those in the placebo (P) group (34-HG vs 12-P) and more gallbladder disease (84-HG vs 62-P). There were no significant differences in several other end points for which power was limited, including fracture, cancer, and total mortality (131-HG vs 123-P deaths).

Based on these results, Dr. Stephen Hulley, the leader of the study, said "Our advice for women with heart disease is that they should not start taking estrogen plus progestin if they are not currently taking the medicine." However, inspite of these negative findings, Dr. Hulley said that a woman on hormones should stay on them.

Note: Dr. Hulley's advice for women already on hormones to stay on them could only help prevent a run to attorneys to sue for damages not prevent heart disease, or prevent a further decline of stock in American Home Products drug company Wyeth-Ayerst, the manufacturer of PremPro[TM] who sponsored the trial anticipating positive results. (Their stock fell 87.5 cents to $51.125 with the news of the study.) Such advice certainly could not be healthy for women on the drugs, especially if they are in their first year on the drugs. If you are taking Estrogen & Progestin you should stop. You don't need to risk your life for Wyeth-Ayerst and its share holders. There are natural alternatives without the side effects. (See Menopause)