The Pharmaceutical Journal Vol 267 No 7158 p109-114
28 July 2001

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American guidance on HRT use in women with heart disease issued

The American Heart Association has issued guidance on the use of hormone replacement therapy (HRT) in women with cardiovascular disease.

The association advises doctors not to prescribe HRT for the sole purpose of preventing heart attacks and strokes in women who already have cardiovascular disease. It adds that the decision on whether to prescribe HRT should be based primarily on non-heart-related benefits and risks (Circulation 2001;104:499).

In women who develop an acute cardiovascular disease event, the association advises that discontinuation of HRT should be considered, or that prophylaxis against venous thromboembolism should be used while the woman is immobile.

The recommendations are, in part, based on the results of the Heart and Estrogen Replacement Study (PJ, 29 August, 1998, p300) and have been produced to provide guidance after several studies of the cardiovascular effects of HRT showed conflicting results (PJ, 15 April 2000, p573 and 13 January 2001, p43).

The new guidance is in line with previous recommendations from cardiologists in the United Kingdom (PJ, 2 September 2000, p323) and the International Menopause Society (PJ, 21 October, 2000, p596).

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