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Hormone therapy may affect heart attack severity in women

Recent studies undertaken at Wake Forest University Baptist Medical Center researcher and colleagues, showed promising signs after research in monkeys suggested //that the type of progestin in hormonal therapy could in fact affect heart attack severity.

At an annual meeting of the North American Menopause Society in Washington, D.C. today, Dr. J. Koudy Williams who is the lead investigator from Wake Forest Baptist formally announced, “One type of hormone therapy limited heart muscle damage to only 5 percent while another resulted in permanent damage to 35 percent of muscle. If we can learn more about this mechanism we might be able to identify better hormone therapies for postmenopausal women."

Hormone therapy had been prescribed for several years as a way to prevent heart vessel disease in women. However after several research studies, including the Women's Health Initiative, it was found that combination therapy (estrogen plus progestin) increased the risk of both a first and second heart attack in older women. These studies though holistic in itself did not look at the amount of heart damage that occurs if a postmenopausal woman has a heart attack. Dr Williams went on to say that it is gravely impotent to know this information as many women take combination therapy drugs for menopausal symptoms or to protect their bones even though the drugs are no longer recommended to prevent heart disease.

In a study of postmenopausal monkeys, Williams and colleagues compared the protestin in Prempro?, the most widely prescribed hormone therapy, with the progestin in Femhrt.

One group of monkeys where given estrogen and the Femhrt progestin, while a second group where given estrogen and the Prempro progestin and a third group where not given any hormone therapy. The monkey were given these drugs for a period of one year in the doses equivalent to those prescribed to women.

The researchers then measured the amount of irreversible muscle damage that resulted after an experimentally produced heart attack. They found that the two progestins produced dramatically different results. The Femhrt group had 5 percent muscle damage, the group that didn't take hormone therapy had 20 percent damage, and the Prempro group had 35 percent damage.

The amount of heart muscle damage can affect risk of a future heart attack and risk of developing heart failure, the inability of the heart to meet the body's demands.

Williams said the results suggest that all hormone therapy drugs are not the same and that there may be better treatments than current formulations. He said, however, that the results are too preliminary to apply to women. The researches still have a long way to go. They want to learn how estrogen alone - without a progestin - will affect the amount of muscle damage, and what caused the differences in muscle damage. They suspect that it is related to the amount of inflammation that occurs after a heart attack. The group, wants to see how soy, which has anti-inflammatory properties, would affect muscle damage.

Other researchers were Irma Suparto, M.D., from the Institute Pertanian Bogor in Indonesia and Jacob Vinten-Johansen, Ph.D., a professor or surgery at Emory University.


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