Postmenopausal estrogen therapy and cardiovascular disease: ten-year follow-up from the Nurse's Health Study

Article Abstract:

The risk of coronary heart disease is influenced by a wide range of factors, including smoking, high blood pressure, high cholesterol, diabetes, and obesity. The role of hormones in the risk of heart attacks continues to be uncertain, however. Particularly controversial is the role of the female hormone estrogen in the risk of heart attacks. Some previous studies have reported that the administration of estrogen to postmenopausal women reduces the risk of heart attacks, while other studies have failed to find such a beneficial effect. The results have now been tabulated for 10 years of follow-up of 48,470 postmenopausal women in the Nurse's Health Study. During the 10 years of follow-up there were 1,263 deaths (from all causes), 405 heart attacks or heart-related deaths, and 224 strokes. Among the postmenopausal women participating for 10 years, 21.8 percent of the total number of person-years included taking hormonal treatment. An analysis revealed that the women taking estrogen replacement therapy after menopause had about half the risk of major coronary disease (relative risk factor = 0.56) than did women not taking hormonal therapy. However, despite the similarity in risk factors between heart attack and stroke, estrogen therapy was found to have no effect on the risk of stroke, that is, women taking estrogen therapy had the same rate of strokes as women not taking estrogen therapy. There has been some concern expressed that although estrogen appears to lower the rate of heart attacks it may also increase the risk of endometrial cancer and perhaps breast cancer. The benefit from reduced heart attack risk seems to outweigh the risk of cancer. However, it should also be emphasized that a properly designed program of estrogen therapy includes progestins, which preserve the beneficial effects of estrogen while reducing the cancer risks. (Consumer Summary produced by Reliance Medical Information, Inc.)

Women, Prevention, Heart attack, Women's health, Menopause, Estrogen, Estrogens

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Weight, weight change, and coronary heart disease in women: risk within the 'normal' weight range

Article Abstract:

Women with body weights in the upper-normal range and those who gain even modest amounts of weight during adulthood may have an increased risk of coronary heart disease (CHD). According to the 1990 U.S. weight guidelines, the desirable weight for women aged 35 and older ranges between 21 and 27 kilograms per meter squared of body height (kg m2). Between 1976 and 1990, researchers surveyed 115,818 women at two-year intervals to determine the affects of the women's medical histories and lifestyles on their risk for CHD. During the follow-up period, the women suffered 1,292 episodes of CHD. As the women's body mass increased, their risk of CHD increased. Even women with body masses between 25 and 28.9 kg m2 had more than two times the risk of CHD than women who weighed less than 21 kg m2. Women who gained at least five kg of weight after age 18 had a significantly higher risk of CHD than women who gained less than five kg after age 18.

Risk factors, Weight gain, Middle aged women

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