Pre-existing risk factor profiles in users and non-users of hormone replacement therapy: prospective cohort in Gothenburg, Sweden
It is too early to recommend hormone replacement therapy (HRT) for the prevention of cardiovascular disease, concludes a Swedish study in this week's BMJ. Dr Kerstin R`dstr`m from Gothenburg University and colleagues report that women who used HRT were at a lower risk of cardiovascular problems before the start of their treatment than women who did not use HRT.
The research team studied 1201 women over a 24 year period and found that 14.9 per cent of them used HRT at some point over the study period. Before the start of their treatment, these women, say the authors, had significantly lower blood pressure, were less obese and belonged to a higher social group than the women who did not use HRT.
Rodstrm et al report that over the last thirty years, many studies have reported beneficial effects of postmenopausal hormone replacement therapy on morbidity and mortality from cardiovascular disease - some indicating an almost fifty per cent risk reduction. The authors say that, based on their findings, reports suggesting beneficial effects of HRT during menopause are likely to have been confounded by the pre-existing differences in the health of users as opposed to non-users - ie users of HRT tend to be women who are less at risk of cardiovascular disease from the outset of their treatment.
On the basis of their findings, say the authors, it is too early to recommend HRT for the prevention of cardiovascular disease before further studies, taking account of such confounding factors, have been conducted.
Contact: Dr Kerstin Rödström, General Practitioner, Department of Primary Health Care, Vasa Hospital, Gothenburg, Sweden Email: Kerstin.Rodstrom@allmed.gu.se