Women who have hormone replacement therapy (HRT) face a lower risk of early death, according to a new study.
Previous research linked HRT to an increased breast cancer risk, which resulted in millions of women avoiding the treatment.
In the new study, women who had therapy showed lower levels of atherosclerosis, or plaque buildup in the heart’s arteries, compared to women not having it. They were also more likely to live longer.
HRT has proven controversial in the past, as some studies associated it with lowering the risk of osteoporosis and improving heart health, while others suggested it could increase risk of cancer and stroke.
The new study bolsters evidence that the therapy, which involves the use of supplemental oestrogen, sometimes along with progesterone or similar hormones, may help improve heart health and overall survival in some women.
“With proper screening and proper follow-up, from a cardiovascular standpoint I believe it is beneficial to take hormone replacement therapy,” said lead author Yoav Arnson, a postdoctoral scientist at Cedars-Sinai Medical Center.
“Our results confirm and enhance previous work in terms of showing lower atherosclerosis. In addition, we’ve shown very clear survival benefits of using hormone replacement therapy.”
For the study, which was presented at the American College of Cardiology’s 66th Annual Scientific Session, researchers analysed the health records of more than 4,200 women who received a coronary calcium scan at Cedars-Sinai Medical Center between 1998 and 2012.
A coronary calcium scan is a CT scan that measures the amount of calcium in the heart’s arteries. Having higher levels of calcium is a marker for the buildup of plaque, which increases the risk of having a heart attack or stroke.
Just over 40% of the women reported having HRT at the time of their calcium scan.
After accounting for age, coronary calcium score and cardiovascular risk factors including diabetes, high blood pressure and high cholesterol, women using HRT were overall 30% less likely to die than those not on hormone therapy.
Women using HRT were also 20% more likely to have a coronary calcium score of zero (the lowest possible score, indicating a low likelihood of heart attack) and 36% less likely to have a coronary calcium score above 399 (indicative of severe atherosclerosis and high heart attack risk).
“Hormone replacement therapy resulted in lower atherosclerosis and improved survival for all age groups and for all levels of coronary calcium,” Arnson said.
“From this we do think it is beneficial, but we would need prospective or randomised studies to determine which groups might not benefit or even be harmed by this therapy.”
In response to the study’s findings, Dr Helen Webberley, GP for Oxford Online Pharmacy, said: “Research such as this is crucial in terms of understanding the potential risks and benefits to patients, both of which must be carefully weighed up when considering HRT.
“The current advice is very clear: if the benefits outweigh the risks then women who want to have HRT should have it.
“There are some known risks, including an increased risk of breast cancer, and VTE (blood clots in the venous system) but, as outlined in this study, there are benefits too.”