HRT reduces risk of heart attack, study suggests

By Anna-Marie Lever
Health reporter, BBC News

image captionLong-term use of HRT has been debated over the last decade

Women who take hormone replacement therapy (HRT) may cut their risk of heart problems, a study suggests, but experts are still cautious about long-term safety risks.

Published in the journal BMJ, the study also found HRT is not associated with an increased risk of cancer or stroke - but past studies have shown a link.

The Department of Health advises women to only use it on a short-term basis.

The researchers traced 1,000 women over 10 years - half of them were on HRT.

Talking about their findings, the paper's authors said: "HRT had significantly reduced risk of mortality, heart failure, or heart attack, without any apparent increase of cancer, deep vein thrombosis or stroke."

However, they stressed that "due to the potential time lag, longer time may be necessary to take more definite conclusions".

Safety concerns about the long-term use of the therapy has been debated by academics over the past decade.

Cancer findings

The women in the study were aged between 45-58 years old and recently menopausal - those given treatment were selected randomly from the group and started it soon after menopausal symptoms began. The trial started in 1992 and ran across a number of Danish hospitals.

HRT replaces female hormones that are no longer produced during the menopause and can help with hot flushes, insomnia, headaches and irritability.

After 10 years, 33 women in the group that had not taken HRT had died or suffered from heart failure or a heart attack, compared with just 16 women who were taking the treatment.

Thirty-six women in the HRT group were treated for cancer compared to 39 who had not taken HRT - of which 17 cases were breast cancer compared to 10 in the HRT group.

They also found that after stopping the therapy, the women continued to see health benefits for six years.

The American Society for Reproductive Medicine said: "This is a very significant piece of research and should reassure the millions of women who turn to hormone therapy for relief of their menopausal symptoms.

"Although the study was not large, the long-term follow-up of 16 years is reassuring as there was no increase in adverse events including cancer.

"This should not be considered the last word on the effects of hormone therapy. More research is needed."

A series of previous studies has linked HRT with a higher risk of breast cancer and heart attack.

A large study which initiated the discussion and looked at a million women, suggested taking it for several years doubled a women's risk of developing breast cancer.

Weighing up the evidence from numerous past studies, some experts warn this new BMJ study does not mean that HRT can now be considered safe.

GP advice

Dr Claire Knight, from Cancer Research UK, said: "This is a small study that wasn't specifically designed to look at whether using HRT was linked to cancer risk.

"This, along with other concerns about how the study was conducted, means we cannot be confident about what it says on the subject of breast cancer risk and HRT.

"A recent comprehensive review funded by Cancer Research UK estimated that just over 3%, around 1,500 cases, of breast cancers in women a year in the UK are linked to using HRT.

"Women should still consult their GP... and discuss the benefits and harms with their doctor to decide what's right for them."

The Department of Health advises that the benefits of HRT outweigh the risks on a short-term basis - of no more than five years. If it is taken for longer, particularly for more than 10 years, the patient should discuss it with their GP.

The Department of Health said it had asked drugs advisory body the National Institute for Health and Clinical Evidence to produce clinical guideline on the menopause, including HRT.

"Doctors are best placed to decide whether a patient should start HRT, as they can discuss the risks and benefits and take into account each patient's medical history."

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