HRT and Women with Diabetes

posted 12/03/02

Women with diabetes who are taking hormone replacement therapy (HRT) may have an advantage when it comes to heart attacks. According to new research, HRT was linked to reducing the risk of heart attack in diabetic women who had not suffered a recent heart attack.

This new finding contradicts a July 2002 study by the Women's Health Initiative that was ended when there was evidence of a possible increased risk of heart attacks from HRT. Assiamira Ferrara, M.D., Ph.D., of the division of research at the Kaiser Foundation Research Institute in Oakland, Calif., says, "Our results are inconsistent with the results from the Women's Health Initiative (WHI), a randomized trial in women without heart disease, which reported a 30-percent increased risk of heart disease in women taking HRT compared with women on placebo."

Dr. Ferrara and fellow researchers observed 24,420 diabetic women with an average age of 65, who had not experienced a heart attack, and 580 women with an average age of 69 who experienced a heart attack in the past year. Of those women free of a recent heart attack, 2,526 used estrogen only and 2,088 used estrogen and progestin. After three years, 256 heart attacks resulted in death and 854 attacks that did not cause death. Researchers found the use of estrogen and progestin was connected to a 22-percent reduced rate of heart attacks when compared to women not taking HRT. Women on estrogen only, had an 11-percent reduced risk of heart attack.

Dr. Ferrara says, "Another key finding was that women taking low or medium doses of estrogen had a lower risk of heart attack, but women taking high doses did not." Women taking low doses of estrogen had a 51-percent reduced risk of heart attack and women taking medium doses of estrogen had a 19-percent reduced risk of heart attack over women not using estrogen. Furthermore, researchers found that high doses of estrogen was linked to a 7-percent higher risk of heart attack.