Some postmenopausal women who receive hormone replacement therapy with estrogen plus progestin experience an increased risk for coronary heart disease (CHD). It has been suggested that this increased risk might be limited to the first years of hormone replacement therapy and to women who start hormone replacement therapy later in menopause. According to a new analysis of data from the Women’s Health Initiative study, recently menopausal women on hormone replacement therapy have a slightly increased risk of CHD within the first few years of use. This study is published in the February 16, 2010 issue of Annals of Internal Medicine.

Researchers from the Harvard School of Public Health, the Harvard-MIT Division of Health Sciences and Technology, and the National Heart, Lung, and Blood Institute examined data on over 16,600 postmenopausal women to estimate the effect of continuous hormone replacement therapy on coronary heart disease risk over time and by the number of years since menopause. They found that recently menopausal women had a slightly increased, but not statistically significant, CHD risk of 29 percent during the first two years of using hormone replacement therapy. This CHD risk was also found in women who started hormone replacement therapy within 10 years of menopause. The increase in risk disappeared after 6 years of use, and thereafter, the researchers identified a possible cardioprotective effect of hormone replacement therapy.

Notably, most women use hormone replacement therapy for less than six years, so they are unlikely to benefit from any cardioprotective effects. The findings of this study therefore support current recommendations for women to take hormone replacement therapy, if needed, to relieve the symptoms of menopause, but to take it at the lowest dose and for the shortest amount of time possible.

Source:

Ann Intern Med. 2010; 152: 211-217.