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Does hormone replacement therapy inhibit coronary artery calcification?
J Shemesh1, Y Frenkel, L Leibovitch
1Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.
Insights
Postmenopausal women using hormone replacement therapy (HRT) showed significantly less coronary calcium. This suggests HRT may reduce coronary calcification prevalence in women without prior heart disease.
Area of Science:
- Cardiology
- Endocrinology
- Radiology
Background:
- Coronary artery disease is a leading cause of mortality in postmenopausal women.
- Hormone replacement therapy (HRT) is used to manage menopausal symptoms.
- The impact of HRT on early coronary artery disease markers is not fully understood.
Purpose of the Study:
- To investigate the association between HRT use and coronary artery calcification.
- To evaluate coronary calcium prevalence in postmenopausal women with and without HRT history.
- To assess HRT's role in early coronary artery disease development.
Main Methods:
- Computed tomography (CT) was used to assess coronary calcium.
- Compared 41 postmenopausal HRT users with 37 age-matched non-HRT controls.
- Analyzed prevalence and extent of coronary calcification.
Main Results:
- Coronary calcification was found in 28.2% of all women studied.
- HRT users had significantly lower coronary calcium prevalence (14.6%) versus non-users (43.2%).
- HRT use was the sole significant predictor of reduced coronary calcification.
Conclusions:
- HRT use is associated with a decreased prevalence of coronary calcification.
- Findings suggest a potential cardioprotective effect of HRT regarding coronary atherosclerosis.
- Further research is warranted to confirm HRT's role in cardiovascular disease prevention.
Objective:
To determine the association between the use of hormone replacement therapy (HRT) and coronary calcium, in postmenopausal women who had no history of coronary artery disease by double helical computed tomography (CT).
Methods:
We used CT to compare the prevalence and extent of coronary calcium in 41 postmenopausal women who were on HRT from the first year of menopause and 37 age-matched controls who had never used HRT.
Results:
Both groups had a similar rate of smoking, hypertension, a positive family history, and hypercholesterolemia. Coronary calcification was observed in 28.2% of the 78 women studied. The prevalence of coronary calcium was significantly lower among HRT users: six of the 47 (14.6%), compared with 16 of the 37 nonusers (43.2%) (P < .01). The recorded risk factors had no effect on the prevalence of coronary calcium. Stepwise logistic regression analysis, including age, coronary risk factors, and HRT use as independent variables, yielded HRT as the only variable determining the presence of coronary calcium (odds ratio = 0.2; 95% confidence interval 0.06, 0.63; P = .006).
Conclusion:
The lower incidence of coronary calcium in the HRT users suggests that HRT is associated with decreased prevalence of the coronary calcification.