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Studies
Sow Doubt Over
Hormone Therapy Benefits
Excerpt
By
Gene
Emery, Reuters Health
Two medical studies released on
Wednesday provided more damning evidence that giving female hormones
to older women does little to improve their health and may in
fact harm it.
The studies found that the treatments
do not protect women from heart disease, as doctors once believed,
and one of the studies found that giving hormones to women actually
increases their risk of heart attack.
Both studies appeared in the New
England Journal of Medicine, which published a separate piece
of research earlier this year suggesting the health risks of estrogen
and progestin treatments for older women outweigh the benefits.
In one study in this week's Journal,
a research team led by JoAnn Manson of Brigham and Women's Hospital
in Boston found that women taking estrogen and progestin increase
their risk of a heart attack by 81 percent in the first year.
The study was the final report
of a major government look at long-term use of combined estrogen-progestin
treatments.
Preliminary findings released last
summer showed that women taking the treatment had an increased
risk of breast cancer, heart attacks and stroke after five years
of use. The study of 16,608 women was ended early once the dangers
of hormone treatment became apparent.
Researchers said the latest findings
mean that most women who are taking the hormones should stop,
and those who have reached menopause should not start.
"Overall, the risk of treatment
outweighed the benefits during 5.6 years of treatment," they concluded
in their study.
The only remaining reason for prescribing
the treatment is to relieve the symptoms of menopause, the Manson
team said.
Drugmaker Wyeth, which says its
drug Prempro makes up nearly half the market of combined estrogen-progestin
treatments, said the study contained "no new findings" regarding
the heart attack data initially published last year.
Wyeth said in a statement that
while estrogen-plus-progestin therapy should not be used to prevent
cardiovascular disease, it remained a "valuable treatment" for
the relief of moderate to severe menopausal symptoms.
The second study, led by Howard
Hodis of the University of Southern California in Los Angeles,
found that the arteries of 150 women taking hormone supplements
clogged just as rapidly as 76 getting a placebo.
For years, conventional medical
wisdom asserted that replacing the estrogen lost after menopause
protected against heart disease because the treatment often lowered
"bad" cholesterol levels and increased the amount of "good" cholesterol.
That produced a "nearly unshakable
belief in the benefits of hormone therapy" in the absence of a
real test of the treatment, said David Herrington and Timothy
Howard of the Wake Forest University School of Medicine in Winston-Salem,
North Carolina.
Even when studies, beginning in
1998, revealed there was no benefit, the belief was so ingrained
the findings were heavily criticized and dismissed, Herrington
and Howard wrote in an analysis in the Journal.
They said this case illustrates
that animal tests and observational studies are no substitute
for studies that use placebos and include large numbers of people.
Reference
Source 89
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