The studies found that the treatments do not protect women from heart
disease, as doctors once believed, and one of the studies found that giving
hormones to women actually increases their risk of heart attack.
Both studies appeared in the New England Journal of Medicine, which published a separate piece of research
earlier this year suggesting the health risks of estrogen and progestin
treatments for older women outweigh the benefits.
In one study in this week's Journal, a research team led by JoAnn Manson of
Brigham and Women's Hospital in Boston found that women taking estrogen and
progestin increase their risk of a heart attack by 81 percent in the first year.
The findings, the researchers said, mean that most women who are taking the
hormones should stop, and those who have reached menopause should not start.
"Overall, the risk of treatment outweighed the benefits during 5.6 years of
treatment," they concluded in their study.
Although hormone supplements may reduce the risk of hip fracture and
colorectal cancer, they increase the likelihood of stroke by 41 percent, the
longer-term risk of a heart attack by 29 percent, and the chance of breast
cancer by 26 percent.
The only remaining reason for prescribing the treatment is to relieve the
symptoms of menopause, the Manson team said.
They ended their study of 16,608 women early once the dangers of hormone
treatments became apparent.
The second study, led by Howard Hodis of the University of Southern
California in Los Angeles, found that the arteries of 150 women taking hormone
supplements clogged just as rapidly as 76 getting a placebo.
For years, conventional medical wisdom asserted that replacing the estrogen
lost after menopause protected against heart disease because the treatment often
lowered "bad" cholesterol levels and increased the amount of "good" cholesterol.
That produced a "nearly unshakable belief in the benefits of hormone therapy"
in the absence of a real test of the treatment, said David Herrington and
Timothy Howard of the Wake Forest University School of Medicine in
Winston-Salem, North Carolina.
Even when studies, beginning in 1998, revealed there was no benefit, the
belief was so ingrained the findings were heavily criticized and dismissed,
Herrington and Howard wrote in an analysis in the Journal.
They said this case illustrates that animal tests and observational studies
are no substitute for studies that use placebos and include large numbers of
people.
SOURCE: New England Journal of Medicine, August 7, 2003.
