Older women on HRT at 'greater risk of heart attack'

A study suggests that Hormone Replacement Therapy has more risks than benefits for women who are many years past the menopause.

But researchers said medication can give younger women both short-term relief from symptoms and a boost to heart health around the time of the menopause.

Almost 6,000 women from the UK, Australia and New Zealand took part in the study funded by the UK's Medical Research Council.

Data from the study, called WISDOM, published yesterday by British Medical Journal Online First, looked at results from 5,692 women with an average age of 63 years and 15 years after the menopause.

The women were given combined hormone therapy, containing oestrogen and progestogen hormones, oestrogen-only therapy or a dummy pill each day.

The women were monitored for an average of 12 months during which there was a "significant increase" in heart attacks, sudden coronary deaths or angina, and blood clots in the combined therapy group compared with non-users.

But there was no difference in rates of stroke, breast or other cancers, fractures, or overall deaths.

Critics claimed yesterday there was little new information because the trial ran for barely a year and few women outside of medical trials start taking HRT in their 60s and 70s.

The WISDOM trial was halted early after a major U.S. study - the Women's Health Initiative - was stopped in 2002 because it found women taking HRT had more heart attacks and strokes than non-users.

This was contrary to previous research which had suggested that oestrogen could protect them from heart problems.

But the early conclusions of the WHI study were overturned earlier this year when re-analysis of the data found the extra risks may apply only to patients in their 60s and 70s, who do not normally use HRT.

Indeed, it was shown to cut heart attacks among women in their 50s, who were at no higher risk of strokes, and they had fewer calcium deposits in the arteries than those not using HRT.

Experts estimate the number of British women taking HRT has fallen from two million to just one million in six years as a result of health scares.

Dr John Stevenson, from the Royal Brompton Hospital in South-West London, said women going through the menopause had been unnecessarily-deterred from taking HRT by studies based on the notion that it should be prescribed for the first time many years later.

He said "The WISDOM trial gives little new information because it did not have enough women enrolled and was stopped early.

"Like the WHI trial, it tells us that when HRT is used in women for whom it is not intended it is giving them an oestrogen overdose.

"Women in the age group for which HRT is recommended for menopausal symptoms can be reassured it doesn't pose a risk to their heart, they are no more likely to suffer strokes and do not have an additional risk of breast cancer from short-term use.

"They will also gain protection from osteoporosis."