The Pharmaceutical Journal
Vol 269 No 7229 p881
21/28 December 2002

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The Lancet (www.thelancet.com)

Further evidence on HRT and cardiac risk

Hormone replacement therapy (HRT) does not reduce the overall risk of further cardiac events in postmenopausal women who have survived a myocardial infarction, according to the results of a major trial.

Researchers found no difference in the frequency of recurrent heart attack or cardiac death at two-year follow-up among a group of some 1,000 women, aged 50–69 years, who were treated either with 2mg estradiol valerate or placebo daily. There was also no difference in all-cause mortality between the two groups.

The study adds to the growing body of research evidence that concludes HRT should not be used for the secondary prevention of heart disease (PJ, 30 November, p774).

However, in an accompanying commentary, Dr Jacques Rossouw, of the United States National Heart, Lung and Blood Institute, says the role of HRT in primary prevention is less clear, and suggests endogenous oestradiol may protect younger women against coronary heart disease.

"If so, then transdermal oestrogen, which more closely mimics human physiology, may eventually hold more promise for primary prevention than oral oestrogens," he says.

The study is available as a PDF file (105K) and is published in this week's edition of The Lancet.

  * PDF files on PJ Online require Acrobat Reader 4 or later.