Response to Heart and Estrogen-Progestin Replacement Study Follow-up (HERS II)
published in July 3 2002 Journal of the American Medical Association (JAMA)
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Response to Heart and Estrogen-Progestin Replacement Study Follow-up (HERS II) published in July 3 2002 Journal of the American Medical Association (JAMA)
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Media Advisory Response to Heart and Estrogen-Progestin Replacement Study Follow-up (HERS II) published in July 3 2002 Journal of the American Medical Association (JAMA) American Heart Association Article The HERS II trial published in this week’s JAMA supports the conclusion from the initial HERS trial that hormone replacement therapy (HRT) does not reduce the risk of cardiovascular events in postmenopausal women with coronary heart disease. “This study supports the American Heart Association’s recommendation (released in July 2001) that hormone therapy should not be initiated for purposes of preventing a second heart attack or death among women with heart disease,” says Lori Mosca, M.D., Ph.D., lead author of the association’s science advisory on HRT. “There are many potential benefits of HRT, but preventing a recurrent heart attack does not appear to be one of them,” she continues. “The jury is still out on the role of HRT in preventing first heart attacks. The ongoing Women’s Health Initiative should provide more definitive data in this area.” For preventing a heart attack or stroke, the association recommends reducing risk factors such as high cholesterol, blood pressure, and tobacco use through lifestyle changes and medication when indicated. The new finding clarifies results from the original HERS trial announced in 1998 after 4.1 years of follow-up. At that time, researchers reported an increase in coronary heart disease (CHD) events among women taking HRT during the first year of treatment compared with those on placebo. However, they found fewer CHD events among the HRT group in years three to five, raising the question of whether longer follow-up might show significant benefit. CHD events in this study included heart attack, coronary revascularization, hospitalization for unstable angina or congestive heart failure, nonfatal ventricular arrhythmia, sudden death, stroke, transient ischemic attack or peripheral arterial disease. The pattern of early increase and later decrease in risk seen in HERS led to the researchers’ initial recommendation that women with CHD should not start HRT, but that those who were already taking hormones for other indications could continue. The question of whether a benefit with regard to CHD events might be seen with longer follow-up was left unanswered. Now, after an additional 2.7 years of follow-up (called HERS II), the researchers conclude that while there are other approved indications for postmenopausal HRT, it should not be used to reduce risk for CHD events in women with CHD.
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