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October 14, 2015
Early Initiation of Hormone Therapy Not Linked to Increased Coronary Risks of Later Initiation

Las Vegas, NV—Late initiation of hormone therapy (HT) might increase coronary heart disease in women, but early initiation appears to have the opposite effect.

That’s according to a new Swedish study presented recently at the 2015 Annual Meeting of The North American Menopause Society (NAMS) in Las Vegas. Background information in the presentation notes that the potential health effects on coronary heart disease from HT have been debated for decades.

“Discrepant results have been reported from observational cohort studies and randomized control trials regarding the association between MHT and risk of coronary heart disease (CHD),” according to the researchers from the Karolinska Institute in Stockholm.

“We realized that, for all of the studies completed, few had taken into consideration the timing of HT initiation in relation to the onset of menopause,” lead author Germ├ín Carrasquilla, MD, said in a NAMS press release. “What we found is that there is a difference with regard to the onset of coronary heart disease depending on when a woman starting taking hormones and when she started menopause.”

For the study, researchers collected data from five population-based Swedish cohort studies involving a total of 74,352 participants from 1991 to 2006. The team estimated percentile differences in the number of event-free years between the exposed group and the unexposed group, with adjustments made for age of the participant, age at menopause onset, educational level, body mass index, smoking status, type of menopause, diabetes, hypertension, and dyslipidemia.

Ultimately, it was determined that an early initiation of HT within 5 years from menopause onset was associated with a decreased risk of future incident coronary heart disease, although late initiation was associated with an increased risk. Over an average of 13.4 years of follow-up, the study recorded 4,714 first-time CHD events.

“With all the conflicting data, studies like this are valuable in helping clinicians and their patients sort out the real impact of hormones and determine who are the best candidates for this therapy,” explained NAMS Executive Director Wulf Utian, MD, PhD, DSc.
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