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HRT may raise heart risk for women with diabetes
Last Updated: 2004-06-28 16:00:34 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Hormone replacement therapy (HRT) used to treat postmenopausal symptoms seems to accelerate the build-up of deposits in the coronary arteries of women who have abnormal glucose tolerance -- a sign of impending or full-blown diabetes -- new research suggests.
"This study provides evidence that hormone therapy should not be used to reduce cardiovascular disease risk in women with diabetes or pre-diabetes," lead author Dr. Barbara Howard, from MedStar Research Institute in Hyattsville, Maryland, said in a statement.
The current report is the most recent to cast doubt on the safety and benefits of hormone replacement therapy.
The most damning evidence came in 2002 when the Women's Health Initiative (WHI) trial was stopped early after HRT was linked to an increased risk of breast cancer, blood-clot events, and stroke.
"The present study is the first to examine the effect of hormone therapy on coronary atherosclerosis" in women with poor tolerance for glucose, the researchers point out.
In the study, Howard's team evaluated the effect of treatment with estrogen, estrogen plus progestin, or placebo in 423 women. The average treatment period was 2.8 years.
According to a report in the American Heart Association's journal Circulation, of the 321 women who had angiograms taken of their coronary arteries, 140 had abnormal glucose tolerance and 181 did not.
In both groups of women, hormone therapy was tied to a drop in "bad" LDL cholesterol levels and a rise in "good" HDL cholesterol levels.
Nonetheless, as mentioned, the progression of coronary atherosclerosis seen with hormone therapy was greater in women with diabetes or pre-diabetes than in those with normal glucose tolerance.
HRT "is associated with a worsening of coronary atherosclerosis ... in women with abnormal glucose tolerance" and, therefore, should not be used in diabetic women, the authors conclude.
SOURCE: Circulation, rapid access issue, June 29, 2004.
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