Under pressure: still drinking the HRT kool-aid?

Posted by Liz on Jul 16, 2012 in heart disease, HRT | 0 comments

Proponents of hormone replacement therapy (HRT) want you to believe that the only negative analyses that are being published are the ones that examine data from the Women’s Health Initiative study. Guess what? That is not true. In fact, there is an evolving body of literature looking at other studies that are coming to similar conclusions: HRT may be a panacea for hot flashes, night sweats and mood swings. But when it comes to cancer and heart disease, you’ve got to be vigilant and aware of your risks. And yet, women continue to be ‘under pressure’ to look the other way, embrace the ‘same as it ever was’ and sift through the facts and fallacies.

Nowhere is the confusion greater than with heart disease. Some data show that long-term HRT protects against heart disease while others suggest that HRT does not.

So does it or doesn’t it?

According to study findings published this month in PLOS ONE, it does not. In fact, the longer you use HRT, the greater your risk of developing high blood pressure, a major, proven factor in heart disease. Here’s what you need to know about this latest information:

• Researchers examined information collected on over 43,000 Australian women who were part of a large-scale study on aging. The women were 45 and older, postmenopausal, had an intact uterus and had not been diagnosed with high blood pressure prior to entering menopause.
• Factors that might influence high blood pressure risk, such as obesity, smoking or lack of physical activity were also examined. On average, the women in the study who used HRT reported having sufficient levels of physical activity, were past (but not current) smokers, drank alcohol and had a healthy body-mass index.
• In the study, the average age that women entered menopause and had ever used HRT was 48 years and most were about 52 years old when they started hormone replacement. Comparatively, women who used HRT developed high blood pressure by age 58.
• The findings showed that younger women (<55 to 61 years) who used HRT had 1.5 times the odds of developing high blood pressure than women who did not. The risk dropped slightly as women got older (between the ages of 62 and 70, HRT users had 1.2 times greater odds of high blood pressure).
• The longer that HRT was used, the greater the odds of developing high blood pressure, with highest risk among women who had used hormone replacement for 6 to 10 years or more. Again, as women in the study age, this risk appeared to decline.

One of the biggest criticisms of the Women’s Health Initiative was that it looked at an older group of women who were not representative of the average age that menopause starts. Here, the data show that in younger women, the odds of HRT being associated with high blood pressure are significant regardless of other potential confounding lifestyle factors. The investigators say that women should be prescribed HRT for the shortest time as possible and that they should be closely monitored for blood pressure before, during and after they stop hormones. Further, they state that “high blood pressure should be conveyed as a health risk for people considering MHT (menopausal hormonal therapy) use.” They also add that these recommendations are aligned with current recommendations for hormone use by the US Food & Drug Administration.

Are you still drinking the HRT kool-aid? You may want to switch beverages, especially if you care about your heart.