A simple blood test may soon be all that is required to know if post-menopausal hormone therapies present an elevated risk of a heart attack, says a new study.
The study is a part of the Women's Health Initiative (WHI) and included 271 cases of coronary heart disease from 40 centres nationwide in the first four years of the trials of estrogen alone and of estrogen plus progestin.
"Because studies on hormone therapy have shown that they may increase heart attacks and strokes, many women have been reluctant to use this treatment," said Paul F. Bray, M.D., the Thomas Drake Martinez Cardeza Professor of Medicine, Director, Division of Hematology at Jefferson Medical College of Thomas Jefferson University.
He added: "However, because hormones remain the most effective remedy for managing post-menopausal symptoms, such as hot flashes and night sweats, many women wanted to take this therapy, but have struggled with the decision because they feared the potential side effects. We found that a simple and widely used blood test may be useful to advise women if they are at an increased risk of a heart attack while undergoing hormone therapy."
The study focussed on levels of blood lipids and high sensitivity C-reactive protein (hsCRP) in women who did not have any previous cardiovascular disease.
According to the findings, those who entered the study with favourable cholesterol levels were less prone to an increased risk of developing heart problems while taking hormones (estrogen alone or estrogen plus progestin), as compared to women with unfavourable cholesterol levels.
Particularly, women with ratios of "bad" cholesterol to "good" cholesterol less than 2.5 did not appear to be at an increased heart disease risk when using hormone therapy, while those with higher ratios of "bad" to "good" cholesterol were known to be at higher risk of coronary heart disease. In addition, this study shows that risk is manifolds if they go for hormone therapy.
Elevated hsCRP appeared to predict higher risk in women taking estrogen, but not in women taking estrogen plus progest when compared to a placebo.
"This report only considered the effects of hormone therapy on coronary disease outcomes. Instead of genetic testing or another more complicated test, we wanted to find a simple and effective way to assess the heart risk of hormone therapy," added Bray.
The findings of the study are reported in the latest edition of the American Journal of Cardiology.