After analysing a subgroup of participants in the Women's Health Initiative (WHI) hormone therapy clinical trials, researchers have suggested that it is the blood cholesterol level that predicts the risk of heart disease due to hormone therapy in postmenopausal women.
This latest analysis of the WHI hormone therapy clinical trials indicated that healthy, postmenopausal women whose blood cholesterol levels are normal or lower are not at increased, short-term risk for heart attack when taking hormone therapy.
Postmenopausal women who had no history of heart disease but whose ratio of low-density lipoprotein (LDL or "bad") cholesterol to high-density lipoprotein (HDL, or "good") cholesterol was less than 2.5 were particularly at no increased risk of heart attack or death due to heart attack from taking oestrogen plus progestin or oestrogen alone, as compared to their peers who did not take hormone therapy, after four years of follow up.
According to Michael S. Lauer, M.D., director of the NHLBI Division of Prevention and Population Sciences, the crucial results of the WHI hormone therapy clinical trials indicate that, overall, neither form of hormone therapy reduces the risk of heart disease in healthy, postmenopausal women, and oestrogen plus progestin increases a women's risk of heart disease.
Besides, oestrogen plus progestin as well as oestrogen alone showed an increased risk of stroke and blood clots, which are grave cardiovascular conditions that the new analysis does not cater to. Combination hormone therapy also increases the risk of breast cancer.
He said that if its is possible to identify which women are more likely to be at increased risk for heart attack when taking hormone therapy, then it can help women and their clinicians make better informed decisions about whether the benefits of hormone therapy have an upper hand over its risks.
However, generally women should not opt for hormone therapy to prevent heart disease, and women who choose to use hormone therapy for menopausal symptoms should use the lowest possible dose for the shortest duration.
Also, all women having increased blood cholesterol levels are at increased risk of heart disease, irrespective of whether they use hormone therapy, and they should take steps to lower their risk.
The study, called "Usefulness of Baseline Lipids and C-Reactive Protein in Women Receiving Menopausal Hormone Therapy as Predictors of Treatment-Related Coronary Events," will be published in the upcoming issue of the American Journal of Cardiology.