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Earlier Hormone Therapy May Benefit Menopausal Women

Starting the therapy earlier may lower the risk of developing heart disease

Preliminary results from a study of more than 74,000 Swedish women found that those who started hormone therapy within five years of the onset of menopause typically stayed free of heart disease for a longer period of time than nonusers — 1.3 years, on average. Those who started hormone therapy later also showed an increase in heart-disease risk.

The study, recently presented at the annual meeting of the North American Menopause Society, evaluated the results of five Swedish studies between 1991 and 2006 that were followed for up to 23 years, HealthDay reports.  According to Dr. Sonia Tolani of the Women’s Center for Cardiovascular Health at New York-Presbyterian Hospital in New York City, “This is in line with what a number of studies have shown.”

At one time, menopausal women were routinely prescribed hormone therapy to help ward off heart disease. That changed in 2002, when researchers reported findings from the Women's Health Initiative (WHI), a large U.S. clinical trial that tested oral hormone therapy against a placebo. Contrary to everyone's expectations, the trial found that hormones — in the form of estrogen plus progesterone — raised women's risk of blood clots, heart attack, stroke, and breast cancer. As a result, prescriptions for menopausal hormone therapy plummeted.

As Dr. Tolani explains, many women in the WHI were well past menopause — in their early 60s, on average. A number of studies since have suggested that hormone therapy is safer for younger women and may even lower their heart disease risk. The new findings add to that evidence, she said.

However, the study cannot prove hormones deserve the credit, Tolani pointed out. "This isn't going to change practice," she said.

The theory, Tolani said, is that younger women can reap the protective effects of hormone therapy, which include lowering "bad" cholesterol. But hormones can also create inflammation, she noted. And older women are more likely to have artery-clogging plaques already. These plaques could worsen or rupture if there is added inflammation in the blood vessels, she said.

Source: HealthDay, September 30, 2015.

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