Researchers suggest that a heart health evaluation should be made mandatory for women before they are prescribed estrogen replacement because research has shown that such hormone therapy could accentuate certain specific pre-existing heart disease risk factors.
MaryFran Sowers, lead researcher and professor of epidemiology at the University of Michigan School of Public Health, said that the research has also shown that in women without existing atherosclerosis, hormone therapy use included some positive effects on lipids but also some negative effects related to heart health.
She said that the study came about in trying to explain what's behind the so-called timing hypothesis.
The timing hypothesis suggests that if a woman implements a hormone therapy program within six years of her final menstrual period, this narrow window is enough to deter heart disease from developing with the onset of menopause.
Sowers, however, said that the findings suggest that explanation isn't quite so simple. Even within the six-year window, there were negative aspects related to heart disease.
Sowers said that while the positive outcomes on HDL and LDL cholesterol levels were observed, researchers also saw negative outcomes in terms of the inflammation process-which can be related to heart disease.
She said that the research shows it's critical for women considering hormone therapy to discuss their heart health with their doctor.
"If the woman walks into the doctor's office with a certain degree of (heart disease) burden already, then she and her health care provider may decide that hormone therapy adds too much to the burden," Sowers said.
"If she doesn't have that burden, they may decide that hormone therapy is an acceptable burden.
"The woman should say to her health care provider, 'What kind of information do we need to gather in order to make an informed decision about whether or not hormone therapy should be pursued.'
'"I understand there could be some heart disease risk, but that the risk may be based upon where I am now, and can you tell me where that is?'" Sowers said.
Sowers said that heart disease risk could be measured through lipid panels, which are standard, but also by measuring inflammation markers.
She said that the tests for inflammation markers exist but their measurement isn't standard when a woman is considering hormone therapy.