Task Force Advises Against
HRT for Heart Disease

NEW YORK (Reuters Health) - Combined estrogen and progestin hormone replacement therapy (HRT) should not be used to prevent heart disease, osteoporosis or other chronic conditions in postmenopausal women, the US Preventive Services Task Force (USPSTF) announced this week.

The task force notes that there are beneficial effects of hormone replacement therapy (HRT) in increasing bone mineral density and reducing the risk of bone fracture and colorectal cancer. However, these benefits do not seem to outweigh the treatment's harmful effects, which include an increased risk of breast cancer, blood clots, heart disease and stroke, according to USPSTF.

In fact, "the harmful effects of estrogen and progestin are likely to exceed the chronic disease prevention benefits in most women," according to the task force's report.

Still, the increased risk of harmful effects stemming from HRT use is modest, at best, so doctors should take into consideration each patient's personal preferences and characteristics that put them at risk for certain conditions. Some women may even decide that, in their case, the benefits of HRT use outweigh the risks, the task force reports.

The task force also advised doctors to discuss with their patients other strategies--such as regular screenings--that are known to be effective in preventing osteoporosis and fractures.

However, they did not address whether women should continue using HRT to treat their hot flashes, mood and sleep disturbances and other symptoms of menopause.

"Decisions to initiate or continue HRT for menopausal symptoms should be made on the basis of discussions between a woman and her clinician," the report indicates.

Finally, the task force said that more evidence is needed before they recommend for or against the use of estrogen, without progestin, to prevent chronic conditions in postmenopausal women who have undergone hysterectomies.

Previous research has found both beneficial and harmful effects associated with estrogen use by these women, including a decreased risk of colorectal cancer and an increased risk of stroke, respectively, but the current studies are "insufficient" to determine whether the benefits outweigh the risks, according to the task force.

Currently posted online at http://www.acponline.org/journals/annals/hrt.htm, the new task force recommendations will be published in the November 19th issue of Annals of Internal Medicine.

The US Preventive Services Task Force is a group of private-sector health experts gathered by the US Public Health Service. Members review the state of knowledge about various medical techniques in preventive healthcare, and make recommendations about their use.

Reference Source 89

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