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A new report is reiterating the fact that women receiving hormone
replacement therapy (HRT), rather than having a reduced risk of
cardiovascular disease as was previously presumed, are actually
at increased risk.
Dr. John A. Blakely, MD, of the Sunnybrook and Women's College
Health Sciences Centre in Toronto, notes that the Heart and Estrogen/Progestin
Replacement Study, a large randomized trial, observed a 1.4% first
year excess of coronary events, which is well beyond the plausible
play of chance.
Over the duration of the study, event totals were similar, but
patients treated with HRT experienced them earlier.
"Since patients in the trial were preselected for satisfactory
adherence to therapy, the net benefit
in practice is likely to be even less," concludes
Dr. Blakely.
He also notes that a previous review of prior studies (meta-analysis)
also found harmful effects of HRT.
"Women with or at high risk of coronary heart disease should
not start HRT," Dr. Blakely concludes, adding that there
is the additional "risk that women without coronary heart
disease might experience even greater
net harm from HRT," as well.
Archives of Internal Medicine
October 23, 2000;160:2897-2900
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