March 2, 2001

Estrogen may not deter heart disease

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Dr. David Herrington speaks about the effects of estrogen replacement on coronary events. (photo by Dana Johnson)

Estrogen may not deter heart disease

The widely held perception that estrogen protects against cardiovascular disease deserves to be reconsidered, according to a leading investigator in the role of estrogen in cardiovascular disease.

Dr. David Herrington, associate professor of Medicine and Cardiology at Wake Forest University Medical Center, spoke about the effects of estrogen replacement on coronary events and on the progression of coronary artery atherosclerosis during the Medicine Grand Rounds as the invited lecturer for the second annual Ann F. Eisenstein Women’s Cardiovascular Symposium.

Herrington recently completed a study showing that hormone replacement therapy does not retard the development of atherosclerosis in the coronary arteries of women.

“The perception that estrogen is cardio-protective is based on data from observational studies rather than from prospective trials,” said Dr. Douglas E. Vaughan, C. Sidney Burwell Professor of Medicine and chief, Division of Cardiovascular Medicine.

“He has led two major clinical trials that have been designed to test the effects of hormone replacement therapy in women with known coronary disease. Both studies indicate that hormone replacement therapy may be of limited or no value in preventing the progression of atherosclerotic cardiovascular disease in women with pre-existing coronary disease,” Vaughan said.

Vaughan said that investigators are still uncertain whether hormone replacement therapy may be used in healthy women as a source of primary prevention. Studies are now underway to test that hypothesis.