Estrogen HRT can limit plaque accumulation in arteries

Estrogen can limit significantly the accumulation of plaque in the arteries of women in their 50s, according to a study published on Thursday in the New England Journal of Medicine, the Milwaukee Journal Sentinel reports (Newson, Milwaukee Journal Sentinel, 6/20).

For the study, JoAnn Manson, chief of preventive medicine at Brigham and Women's Hospital in Boston, and colleagues examined a subset of women who participated in the Women's Health Initiative (Rubin, USA Today, 6/21).

The 1,064 participants were ages 50 to 59 and had undergone surgically induced menopause through a hysterectomy when the study began. Half of study participants took Wyeth's estrogen pill Premarin and half took a placebo (Maugh, Los Angeles Times, 6/21). Study participants took estrogen or a placebo for 7.5 years, after which they underwent cardiac scans to determine the level of accumulation of plaque in their arteries (Stobbe, AP/Philadelphia Inquirer, 6/21).

According to the study, participants who took estrogen were 30% to 40% less likely than those who took a placebo to have large amounts of plaque in their arteries, an indicator of heart attack risk (Emery, Reuters, 6/21). In addition, participants who took estrogen on a regular basis were 60% less likely than those who took a placebo to have large amounts of plaque in their arteries, the study found (Parker-Pope, Wall Street Journal, 6/21). However, participants who took estrogen had a higher risk for stroke than those who took a placebo, according to the study (AP/Philadelphia Inquirer, 6/21).

Comments
Manson said the study does not indicate that women should take estrogen to reduce their risk for heart attack (Wall Street Journal, 6/21). "Hormone therapy should not be used for the express purpose of preventing cardiovascular disease due to other known risks, and it should be limited to treatment of menopausal symptoms at the lowest dose for the shortest duration necessary," Manson said (Reuters, 6/21). Elizabeth Nabel, director of the National Heart, Lung and Blood Institute, which sponsored the study, said that the results "do not alter the current recommendations that, when hormone therapy is used for menopausal symptoms, it should only be taken at the smallest dose and for the shortest time possible" and "never be used to prevent heart disease."

Manson said that the results of the study "provide some additional reassurance for women who have been denying themselves relief" from hot flashes and other symptoms of menopause (Los Angeles Times, 6/21). A medical consultant for Wyeth said that many women should begin to take estrogen after they reach menopause and continue treatment indefinitely (Reuters/Washington Times, 6/21).

An abstract of the study is available online.

NPR's "All Things Considered" on Thursday reported on the study (Knox, "All Things Considered," NPR, 6/21). Audio and a partial transcript of the segment are available online.