03 Aug Postmenopausal Effect of Estrogen on Cardiovascualar Events and Hot Flashes
MedicalResearch.com Interview with:
S. Mitchell Harman, M.D., Ph.D.
CAPT US Public Health Service, retired
Professor, Clinical Medicine, U of AZ College of Medicine
Interim Chief, Dept. of Internal Medicine
Chair, IRB Subcommitee
Phoenix VA Health Care System
Phoenix, AZ 85012-1892
Medical Research: What are the main findings of the study?
Dr. Harman: The major findings are:
1. Neither transdermal nor oral estrogen treatment significantly accelerates or decelerates rate of change of carotid artery intimal medial thickness (CIMT) in healthy recently menopausal women.
2. Both estrogen treatments have some potentially beneficial effects on markers of CVD risk, but these differ depending on the route of estrogen delivery with improvements in LDL and HDL cholesterol seen with oral, and reduced insulin resistance with transdermal.
3. No significant effects were observed on rate of accumulation of coronary artery calcium.
4. Women reported significant relief of vasomotor (hot flush) symptoms with both estrogen treatments
Medical Research: Were any of the findings unexpected?
Dr. Harman: We had expected to see a reduced rate of carotid artery intimal medial thickness change with estrogen. The lack of significant improvement was unexpected.
Medical Research: What should clinicians and patients take away from your report?
Dr. Harman: Four years of estrogen treatment in healthy recently menopausal women is unlikely to worsen risk of cardiovascular events and is therefore a relatively safe strategy for relief of menopausal symptom.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Harman: Future research to examine effects of longer term hormone treatment on coronary calcium accumulation and CVD event rates after early menopausal initiation of treatment is warranted.
Harman SM, Black DM, Naftolin F, Brinton EA, Budoff MJ, Cedars MI, et al. Arterial Imaging Outcomes and Cardiovascular Risk Factors in Recently Menopausal Women: A Randomized Trial. Ann Intern Med. [Epub ahead of print 29 July 2014] doi:10.7326/M14-0353