Article Abstract:
More clinical trials are needed to determine whether estrogen replacement therapy (ERT) lowers the risk of coronary heart disease (CHD) in women. A 1998 study of 2,768 postmenopausal women with existing CHD found that ERT did not reduce the risk of heart attack or death from CHD. However, many observational studies have concluded that ERT can protect women from CHD. One problem with these studies is that the women may have other behaviors that lower their risk independently of ERT use. In a study of men with CHD, those who took estrogen had the same rate of heart attacks as those who took a placebo despite the fact that estrogen lowered blood cholesterol levels.
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Article Abstract:
Estrogen replacement therapy should benefit most women except possibly those with a high risk of breast cancer and a low risk of heart disease. Researchers used computer modeling to estimate which groups of postmenopausal women would benefit from estrogen replacement therapy. The risk of developing heart disease, breast cancer, and hip fracture was estimated from the Framingham study and other studies. Estrogen therapy would extend the lives of most women by several years. However, women with a family history of breast cancer and no risk of heart disease or hip fracture may not benefit.
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Article Abstract:
Estrogen replacement therapy may not lower the risk of heart attack or death in postmenopausal women with coronary heart disease. Researchers randomly assigned 2,763 postmenopausal women with coronary disease to take estrogen plus medroxyprogesterone acetate or a placebo daily. After an average follow-up of 4.1 years, the rate of heart attack or death from coronary heart disease was similar in both groups. This occurred despite the fact that the women on hormone therapy had lower levels of LDL, or 'bad' cholesterol and higher levels of HDL, or 'good' cholesterol.
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