( Women who initiate hormone therapy clos...)Starting Time of Hormone Therapy may Augment the Risk of Coronary Heart Disease,Health

Women who initiate hormone therapy closer to menopause tend to have a reduced risk of coronary heart disease compared to women who begin treatment// further from menopause, according to a study.

Studies examining the effects of the use of postmenopausal hormone therapy on coronary heart disease (CHD) have yielded mixed results, depending on the type of study conducted. There may be a number of reasons for the differences, including the timing of initiation of hormone therapy, according to background information in the article.

Jacques E. Rossouw, M.D., of the National Heart, Lung, and Blood Institute, Bethesda, Md., and colleagues conducted a secondary analysis of data from the Women’s Health Initiative (WHI) trial to determine whether the effects of hormone therapy on risk of cardiovascular disease varied by age or years since menopause began. The WHI trial included 10,739 postmenopausal women who had undergone a hysterectomy who were randomized to conjugated equine estrogens (CEE) or placebo and 16,608 postmenopausal women who had not had a hysterectomy who were randomized to CEE plus medroxyprogesterone acetate (CEE + MPA) or placebo. Women age 50 to 79 years were recruited to the study from 40 U.S. clinical centers between September 1993 and October 1998.

"Although not statistically significant, these secondary analyses suggest that the effect of hormones on CHD may be modified by years since menopause and by the presence of vasomotor symptoms [such as hot flashes or night sweats], with higher risks in women who were 20 or more years since menopause (or aged 70 years or greater). Coronary heart disease tended to be nonsignificantly reduced by hormone therapy in younger women or women with less than 10 years since menopause, and the risk of total mortality was reduced in women aged 50 to 59 years," the authors write.

"We did not have adequate statistical power to assess outcomes in the women aged 50 to 54 years or
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