Hormone Replacement Therapy Helps Lower Cholesterol in Elderly Women

Older women may have a new weapon in their fight against coronary heart disease (CHD). A study in the May 1 issue of the Annals of Internal Medicine reports that hormone replacement therapy (HRT) lowers their levels of the type of cholesterol which leads to CHD.

CHD is the leading cause of death among older women. Caused by fatty plaques that build up in the walls of arteries in the heart, CHD prevents adequate blood flow to the heart muscle and can lead to a heart attack. Thus, anything that reduces the risk of developing these fatty deposits in artery walls may in turn reduce the risk of dying from CHD.

Two types of cholesterol affect arterial fat deposition: Low-density lipoprotein (LDL) is known as “bad cholesterol” because it worsens fatty deposits. Conversely, high-density lipoprotein (HDL) is called “good cholesterol” because it can protect blood vessels from blockage due to fatty deposits.

Authors of the study, led by Ellen F. Binder, MD of Washington University School of Medicine in St. Louis, wanted to know how HRT affected both HDL and LDL levels in elderly women.

To do this, the researchers recruited 59 women over the age of 75 and measured the HDL and LDL concentrations in their blood. After being randomly divided into two groups, 39 of the women began HRT, which consisted of a pill containing 0.625 mg of the hormone estrogen each day.

If a participant still had her uterus, she was also given progesterone, another hormone, to prevent possible side effects estrogen can have on the uterus. The remaining 20 women received an inactive placebo for the duration of the study. After 9 months of treatment, the women’s HDL and LDL levels were measured again and compared to the original concentrations.

The researchers found that compared to the placebo group, the women who received HRT had significantly reduced LDL levels and increased HDL levels. Both of these changes can benefit cardiovascular health.

However, many of the women who received estrogen treatment experienced adverse side effects, namely breast discomfort (69 percent) and vaginal bleeding (78 percent).

The authors said, “Because most CHD-related events occur after the age of 65 years, strategies to delay or prevent CHD among the elderly is of great clinical importance.”

They continue, “In summary, HRT favorably altered the lipid profile in elderly women and was generally well tolerated. It can be speculated that HRT may reduce the risk for CHD in elderly women.” The authors concluded that further studies are needed to demonstrate the actual effect of HRT on CHD.

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