Estrogen May Help Arteries, Study Says; But Experts Say More Research Needed to Clarify Benefits, Ri

Jun 21, 02:05 PM

Current Headlines: By KAWANZA NEWSON

After several years of getting a bad rap, estrogen has been linked to a possible unintended benefit to some postmenopausal women, according to a new study.

In an intriguing finding, estrogen therapy significantly slowed plaque buildup in the arteries of women in their 50s, suggesting that the hormone could protect against heart disease.

However, experts say more studies are needed to clarify whether the results translate to fewer heart attacks, deaths or new diagnoses of heart disease.

"This is reassuring for certain women who are menopausal and somewhat skeptical about taking hormones," said Jane Kotchen, a professor of epidemiology at the Medical College of Wisconsin who was involved in the study. "But this doesn't change the overall recommendation that hormone therapy should just be used for relief of (menopausal) symptoms and taken in the lowest dose possible for the shortest period of time."

"The big fears associated with estrogen are blood clots and an increased risk of cancer," said Patrick McBride, a professor of medicine at the University of Wisconsin School of Medicine and Public Health in Madison.

And despite the current study, those risks still remain, he said.

The results, published today in the New England Journal of Medicine, are from the Women's Health Initiative, a government- funded study best known for its landmark finding in 2002 that taking estrogen and progestin after menopause raised the risk of certain cancers, including breast cancer, and heart problems. The studies involved more than 48,000 postmenopausal women, including nearly 1,200 from Milwaukee, who were followed for about eight years.

Although that part of the study was halted in July 2002, a smaller portion involving women taking estrogen alone continued until March 2004, when participants were told to stop taking the pills because of an increased risk of stroke. Taking estrogen without progestin raises the risk of uterine cancer, so estrogen alone is prescribed only for women who have had a hysterectomy.

Other disturbing findings along the way have included results showing that eating a low-fat diet would not reduce women's risk of cancer or heart disease, and that calcium and vitamin D supplements don't protect against bone fractures and colon cancer, as was thought. Estrogen also is believed to slightly increase the risk of Alzheimer's disease and other forms of dementia in postmenopausal women.

But in 2006, the Women's Health Initiative researchers published additional findings from the estrogen-only study showing that women who were younger than 60 at the beginning of the study might have a lower risk of heart attack or procedures to reopen clogged arteries.

"This study has had a lot of interesting findings and has provided a lack of clarity on what women should do," said Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, which was not involved in the study.

"However, this (new study) adds a new step of clarity that will help women," he said. "Still, every woman's situation is unique, and it's important to consult with a doctor to decide what's best for them."

The current study was an analysis of data from almost 1,064 women, including 40 from Milwaukee, involved in the estrogen-only trial. The women, who were ages 50 to 59 at the beginning of the study, were followed for about seven years. About a year after their treatment ended, researchers measured levels of calcium plaque in their coronary arteries and found that estrogen reduced calcium levels by 30% to 40%. Women who took their study medications regularly had a 60% lower risk of severe coronary calcification.

Coronary calcium is a strong predictor for future risk of coronary artery disease, said JoAnn Manson, lead author of the study and chief of preventive medicine at Brigham and Women's Hospital in Boston.

"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," Manson said. Still, "a lot more research is needed to understand the benefits and risks of hormone therapy in younger, recently menopausal women."

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