The Journal of the American Medical Association published a new study this week that found women who begin hormone therapy in their 50s may have less of a risk of coronary heart disease due to hormone therapy than women in their 60s and 70s.

The abstract of the study and a press release (PDF) describing the findings are both available to the public.

The findings were based on further analysis of data gathered during the Women’s Health Initiative study, which found that women taking Prempro, a combination estrogen and progestin drug, had a higher risk of heart attacks, blood clots, strokes and breast cancer. Those who took estrogen alone had a higher risk of blood clots and strokes. [View a summary of the results.]

For this new analysis, investigators looked more closely at the health risks broken down by age (50 to 59, 60 to 69, and 70 to 79) or in years since the onset of menopause (less than 10, 10 to 19, and 20 or more).

Jacques Rossouw, M.D. chief of the Women’s Health Initiative Branch at NHLBI, and lead author of the study, told The New York Times that if the concern is heart attack risk, “we were as clear as could be that there seems to be a window of opportunity to use it in that short interval, but there is not a window of opportunity into the future … And we know for sure that if you start taking it in older age, it is bad news for heart disease.”

Interestingly, the Wall Street Journal and The New York Times emphasized different aspects of the study, as evidenced by each paper’s headline. “New Study Reassures Most Users of Hormones,” proclaimed the WSJ in a lengthy frontpage story that ran above the fold (available online to subscribers only). The Times, meanwhile, covered it on page A10 under the headline “Health Risk to Older Women Is Seen in Hormone Therapy.”

Patricia Yarberry Allen, M.D., a gynecologist affiliated with New York-Presbyterian Hospital and founding board member of Women’s Voices for Change, said the new information is “very good news for women who are having significant symptoms and who are in the early part of their menopausal transition.”

“Women in this age group can be reassured by the new findings that hormone therapy is unlikely to cause heart attacks,” she said, adding that the WHI study has been hugely influential in helping doctors determine the appropriate course of care.

“It was previously not uncommon for doctors to prescribe hormones to patients who otherwise would not have taken them to prevent heart disease. The WHI study answered the important question it had set out to answer: Will estrogen prevent heart disease? The answer is no, and as women age hormone therapy increases their risk of cardiovascular disease,” said Dr. Allen. “Physicians and women in midlife should be grateful that scientists are continuing to evaluate the massive amounts of data collected in this important study.”

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  • Carolyn Hahn April 10, 2007 at 11:09 pm

    They weren’t safe, now they are, sort of, but only for a short time and better if you skip them altogether? This is making my head spin. Tangential funny: I was in New Mexico last week, where my aunt and uncle have just moved to the Jemez mountains and where my uncle seems to have resurrected from the Albuquerque house my grandmother’s circa 1930 obstetrics & gyno textbook (she was a nurse — hated it, my uncle said — wanted to be a lawyer, but I don’t think women circa 1927 did that much with no money).
    Anyway, in the textbook — which I read cuz it was, you know, the middle of nowhere — it mentions that a few “hysterical” (sic) women had a harder time with menopause. But that’s practically what at least one of those articles said, that when it came down to it, dressing in layers, fans, and cool drinks worked as well as anything else and were safer than any meds. So maybe not much has changed since 1930 except they left out the word “hysterical”?

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  • Faith Childs April 10, 2007 at 6:33 pm

    The evaluation of the different spin on the data presented by the JAMA findings regarding menopause–with the Wall Street Journal emphasizing one position on hormone therapy and the New York Times another– is quite confusing. As I read the story when it was first reported, I wondered whether the two news sources had considered the same data.
    This was not the first time that there had been differing reports on the same research findings.
    The difference in emphasis between the two news sources underscores the need for clear, reliable, accurate analysis and information on menopause.
    Kudos to Dr. Pat for providing that clarity about this study. Where women’s health is concerned, informed consumers of health care information should look to this space for more straight talk.

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