Are Fewer MIs in Women in Recent Years Due to Less HRT?

Two recent trends – fewer heart attacks (myocardial infarctions, or MIs) and a decline in hormone replacement therapy (HRT) – have led to speculation of a relationship. A study reported in the journal Medical Care tackled this hypothesis.

Up to 2002, physicians thought that taking HRT halved the risk of coronary heart disease in menopausal women. Then the Women’s Health Initiative study report showed that in fact, HRT had the opposite effect. Since then, the use of HRT has declined by half – from about 30% of women to 15% of women.

The researchers analyzed data from US death records, hospital discharge reports, and national surveys of medication usage on women aged 40 to 79 over a 5-year period. They found that for every 10,000 fewer HRT users in one year, there were 25 fewer heart attacks. There was no linkage between HRT use and the frequency of stroke, however.

Dr Goldberg, a New York City cardiologist, believes there may be other reasons for the decline in heart attack rates in women. For instance, the decline in HRT use coincides with increased efforts among cardiologists to make the risks for heart attack in women better known, along with the need for screening for cardiovascular problems.

I believe we should be pleased that the use of HRT has declined, together with the frequency of MI in women. Let’s take this win-win outcome at its face value, until further clinical study results tell us otherwise.