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Estrogen therapy and coronary-artery calcification
Joann E Manson1, Matthew A Allison, Jacques E Rossouw
1Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA. jmanson@rics.bwh.harvard.edu
The New England Journal of Medicine
|June 22, 2007
Summary
Estrogen therapy in postmenopausal women aged 50-59 was associated with reduced coronary artery calcium, a marker of plaque burden. This suggests a potential benefit for cardiovascular health, though estrogen
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Women's Health
Background:
- Coronary artery calcification indicates plaque burden and predicts cardiovascular events.
- Estrogen therapy's impact on coronary artery calcium requires investigation.
Purpose of the Study:
- To examine the relationship between estrogen therapy and coronary artery calcium.
- To assess the effect of conjugated equine estrogens on coronary artery calcification in postmenopausal women.
Main Methods:
- Ancillary substudy of the Women's Health Initiative randomized clinical trial.
- Computed tomography performed on 1064 women aged 50-59 years, treated with conjugated equine estrogens or placebo.
- Coronary artery calcium (Agatston) scores measured after a mean of 7.4 years of treatment.
Main Results:
- Mean coronary artery calcium scores were lower in the estrogen group (83.1) versus placebo (123.1) (P=0.02).
- Estrogen use was associated with reduced odds of coronary artery calcium (ORs ranging from 0.69 to 0.78).
- Higher adherence to estrogen therapy correlated with significantly lower odds of coronary artery calcium.
Conclusions:
- Estrogen therapy in women aged 50-59 was linked to decreased coronary artery calcified plaque burden post-trial.
- Estrogen has complex biological effects that may influence cardiovascular risk through various pathways.
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