Jun 21, 2007Estrogen Therapy and Coronary Artery Calcification
Women aged 50-59 who took estrogen show a reduced risk of coronary plaque buildup
“These findings lend further support to the theory that estrogen may slow early stages of plaque buildup and lead to less hardening of the arteries supplying blood flow to the heart,” said Manson, lead author of the study and chief of Preventive Medicine at BWH. “These results, together with previous WHI findings about lower rates of coronary bypass surgery and angioplasty for younger women who take estrogen, provide reassurance for recently menopausal women who are considering estrogen therapy for the short-term treatment of menopausal symptoms,” added Manson, who is also one of the principal investigators of the WHI.
Coronary artery calcium was measured by cardiac computed tomography (CT scans) in 1064 women who were aged 50-59 years and randomly assigned to estrogen-alone therapy (conjugated equine estrogens, 0.625 mg/d) or to placebo at the start of the WHI trial. After an average of 7.4 years of treatment, the women receiving estrogen were 30-40% less likely to have severe coronary artery calcium than women receiving placebo. Among women who were taking their study medications regularly, women receiving estrogen had a 60% lower risk of severe coronary calcium. These risk reductions were statistically significant.
The authors caution, however, that the new study should not be interpreted to mean that women should take estrogen to protect their hearts and stress that more research is needed to evaluate the effects of estrogen in younger women.
“Although these findings indicate that estrogen therapy in younger menopausal women is related to less plaque in the arteries supplying the heart, this does not mean that estrogen should be taken for the express purpose of preventing cardiovascular disease,” concluded Manson, who is also a professor of medicine at Harvard Medical School and author of Hot Flashes, Hormones & Your Health. “Estrogen is known to have other risks and should be used only for the treatment of menopausal symptoms at the lowest dose for the shortest duration necessary,” she added.
The effect of estrogen on the development of atherosclerosis in recently menopausal women is also being studied in the Kronos Early Estrogen Prevention Study (KEEPS). The KEEPS trial is comparing low doses of oral versus transdermal (patch) estrogen in the prevention of blood vessel narrowing (additional information about the study, which is still recruiting participants, is available at keepstudy.org).
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