From: LARRY KLAES (ljk4_at_msn.com)
Date: Thu Jul 22 2004 - 17:35:54 PDT
----- Original Message -----
From: cunews_at_cornell.edu<mailto:cunews_at_cornell.edu>
To: CUNEWS-HEALTH-L_at_cornell.edu<mailto:CUNEWS-HEALTH-L_at_cornell.edu> ; CUNEWS-SCIENCE-L_at_cornell.edu<mailto:CUNEWS-SCIENCE-L_at_cornell.edu>
Sent: Tuesday, July 13, 2004 4:37 PM
Subject: Cornell News: HRT benefits younger women
Hormone replacement therapy could have more benefits than risks when
started early in menopause, new study finds
FOR RELEASE: July 13, 2004
Contact: Susan S. Lang
Office: 607-255-3613
E-mail: SSL4_at_cornell.edu<mailto:SSL4_at_cornell.edu>
ITHACA, N.Y. -- Don't categorically reject hormone replacement
therapy (HRT) just yet: When women begin HRT before age 60, their
risk of death is 39 percent less than women not on hormones,
according to a new survey.
The findings are based on a Cornell University-Stanford University
meta-analysis (a study of other previously published studies), which
pooled the results of 30 clinical trials of HRT with almost 27,000
women.
"The results of our analysis indicate that the benefits of HRT
outweigh the risks in women who have recently entered menopause,"
says Edwin E. Salpeter, who did the statistical analyses for the
study. Salpeter is a professor of physics emeritus at Cornell and
the 1997 Crafoord Prize laureate who has turned his interest to
medical issues in recent years.
The first author of the study, which is published in the July issue
of the Journal of General Internal Medicine (Vol. 19:7, 2004), is his
daughter, Shelley R. Salpeter, M.D., a clinical professor of medicine
at Stanford University School of Medicine and a physician at Santa
Clara Valley Medical Center in San Jose, Calif.
The new findings appear contrary to two large, well-publicized
studies, the Heart and Estrogen/Progestin Replacement Study and the
Women's Health Initiative, which found no difference in mortality
rates for those taking HRT or a placebo. Women taking HRT, these two
studies found, had increases in breast cancer, stroke, heart attacks
and pulmonary embolism and decreases in colon cancer, hip fractures
and diabetes mellitus. The conclusion from these trials was that the
risks of HRT outweighed the benefits in these patients. However,
these findings were based on samples of women whose mean age was 65
years at the start of the trial.
However, an earlier survey, the Nurses' Health Study, says Shelley
Salpeter, "was a large prospective study that found that women who
started treatment within two years of menopause had a total mortality
risk of 0.63 that of nonusers. Our findings are consistent with this
result and suggest that HRT may help prevent and perhaps even halt
the progression of cardiovascular disease when started in women in
early postmenopause."
She notes, however, that the accumulated evidence suggests that once
heart disease has already developed, HRT has no effect in reversing
the process. In fact, heart attacks could even be increased in this
older age group due to an increased risk for blood clots.
"The beneficial effects of HRT in younger postmenopausal women appear
to be due to HRT's ability to increase high-density lipoproteins
("good" fats) and reduce low-density lipoproteins ("bad" fats),
glucose, weight, insulin levels, the incidence of new-onset diabetes
and a handful of other risk factors for heart diseases," says Shelley
Salpeter.
The Salpeters point out that the meta-analysis found no change in
breast cancer deaths or total cancer deaths in women of all ages on
HRT compared with those not on it, and it also showed a significant
decrease in the risk of deaths from causes other than cancer or
cardiovascular events, perhaps due to HRT's other benefits. These
other benefits include a 35 percent reduction in hip fracture and
new-onset diabetes mellitus and a 60 percent reduction in recurrent
urinary tract infections (which can lead to fatal sepsis). The
authors conclude that each woman should make the decision regarding
hormone replacement on an individual basis, taking into consideration
her age, the degree of bothersome postmenopausal symptoms and her
underlying health-risk factors.
The other co-authors of the study are Judith M.E. Walsh, M.D., of the
University of California-San Francisco; and Elizabeth Greyber, M.D.,
and Thomas M. Ormiston, M.D., both of the Santa Clara Valley Medical
Center. The study was funded, in part, by the Santa Clara Valley
Medical Center and the University of California-San Francisco.
Related World Wide Web sites: The following sites provide
additional information on this news release. Some might not be part
of the Cornell University community, and Cornell has no control over
their content or availability.
oFor an electronic copy of the paper:
-30-
The web version of this release may be found at
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