|
Estro-gain
.. Learn More
Estrogen therapy may benefit thin
women more
Women who take estrogen after menopause
have a lower overall risk of death, but thin women appear to reap
the most heart benefits, researchers report.
In a 12-year study of nearly 300,000
postmenopausal women, estrogen use at the start of the study was
linked to a reduction of more than 50% in the risk of dying from
heart disease in the leanest women.
But taking estrogen did not appear
to affect the heaviest women's risk of dying from heart disease.
The findings suggest that women
and their doctors should consider body mass index (BMI), a ratio
of weight and height used to determine obesity, when making decisions
about taking hormones, the study's lead author told Reuters Health
in an interview.
"BMI is something to take into account,"
said Dr. Carmen Rodriguez, of the American Cancer Society in Atlanta,
Georgia. If an obese woman is considering taking hormones at menopause
to reduce her risk of heart disease, she should keep this in mind,
according to Rodriguez.
Generally, a BMI lower than 25 is
considered normal or thin, between 25 and 30 is overweight, and
30 or higher is obese. BMIs were lower than 22 in the thinnest women
in the study and higher than 30 in the heaviest women.
Rodriguez and her colleagues did
not investigate the reasons why estrogen therapy appeared to have
less of an effect on the hearts of heavier women, but they point
out that heavier women naturally tend to have higher circulating
levels of estrogen after menopause than thinner women. Adding extra
estrogen in heavier women may not make as much of a difference,
the researchers suggest.
Although the current study enrolled
only women who did not have heart disease, Rodriguez's team notes
that it may help explain why a previous study, the HERS trial, did
not detect any cardiovascular benefits of estrogen in women with
heart disease.
They point out that 55% of the women
in the HERS trial had a BMI greater than 27.
In the current study, which included
women from all 50 states as well as Puerto Rico and the District
of Columbia, participants filled out a health questionnaire in 1982.
None of the women had heart disease or cancer at the start of the
study. By the end of 1994, about 13% of the participants had died.
Women who were taking estrogen at
the start of the study were about 18% less likely to die from any
cause than women who had never taken hormones, according to the
report in the January 15th issue of the American Journal of Epidemiology.
And women who had used estrogen, but who were not taking it at the
start of the study, had a 14% reduction in the risk of dying.
The investigators also found that
the overall death rate from cancer was somewhat lower in estrogen
users.
In her comments to Reuters Health,
Rodriguez voiced a few caveats in interpreting the study.
Since women who take hormones at
menopause tend to be healthier than those that do not, the researchers
tried to account for differences in health as much as possible,
she explained. However, she noted that when the study was conducted,
most women took estrogen to treat symptoms of menopause such as
hot flashes, since the potential benefits to the heart were not
well known. This means that the study may have been skewed towards
women who had more menopausal symptoms, according to Rodriguez.
She also noted that the women in
the study were taking estrogen alone, while most women today take
it in combination with the hormone progestin.
|
