Many women abandoned HRT after the first WHI results were released in 2002.
This study aimed to see if standard biomarkers could predict which women would have heart problems while using HRT.
Researchers obtained cholesterol and C-reactive protein (CRP) levels related to 271 coronary heart disease "events" occurring in women during the first four years of the WHI, and compared them to a group of more than 700 controls.
As it turned out, the ratio of LDL ("bad") cholesterol to HDL ("good") cholesterol at the beginning of the trial did seem to predict which women were prone to problems while taking HRT.
"If the ratio was less than 2.5, then there was no increased risk of heart attacks when using hormones," Bray said. "If it was greater than 2.5, there was an increased risk. We did not find that CRP substantively helped us in this prediction." The findings were true both among women taking estrogen alone and among those taking estrogen plus progestin.
Women with high ratios of "bad" to "good" cholesterol have a higher risk of coronary heart disease anyway. Taking hormones just increased that risk, the researchers said.
The tests did not predict the risk of stroke.
"If a woman were to come in, after assessing all of her organs, if you decide her heart is one of the things you're worried about most, you would assess her blood cholesterol level, and if the ratio was greater than 2.5, I would discourage her from using HRT," Bray said. "If the ratio were less than 2.5, you could provide some reassurance that the risk of having a heart attack is not increased.
Visit the National Heart, Lung, and Blood Institute for more on the Women's Health Initiative.
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