Women taking HRT pills face a lower risk of deadly heart failure

Women taking hormone replacement therapy to cope with the menopause may reduce their risk of heart failure.

A study has found HRT may have other health effects beyond tackling night sweat and hot flushes.

Women taking the pills for at least three years do not appear to show the early warning signs of heart failure, which affects half a million people in Britain. 

Their hearts are less likely to have enlarged chambers, showing blood has been trapped by the organ failing to pump hard enough.

Previous evidence suggests oestrogen, which is lost during the menopause but topped up by HRT, may prevent the death of heart muscle cells.

This could be a vital protection for women, who are less likely than men to suffer heart disease right up until the menopause, but see their risk soar in middle age. 

Currently, 2.3 million women in Britain take HRT, which relieves the symptoms of the menopause but has been linked to an increased cancer risk.

A study found HRT may have other health effects beyond tackling night sweat and hot flushes

Lead author Dr Mihir Sanghvi, from the research team at Queen Mary University of London, said: ‘This is the first study to look at the relationship between the use of menopausal hormone therapy and subtle changes in the structure and function of the heart, which can be predictors of future heart problems.

‘Using UK Biobank data, we’ve now been able to show that the use of menopausal hormone therapy is not associated with any adverse changes to the heart’s structure and function, and may be associated with some healthier heart characteristics.’

Experts have long warned that HRT increases the risk of certain cancers – but recent studies have shown these risks are not as significant as feared.

There is great interest in HRT and heart disease, as well as cancer, because the menopause raises women’s risk of heart disease. 

They no longer have oestrogen in their body, to produce eggs and make a baby, so lose the hormone’s protective effects on their heart and blood vessels.

The latest study looked at more than 1,600 post-menopausal women, almost a third of whom had used HRT for the last three years.

IS THERE ANY RISK USING HRT FOR WOMEN GOING THROUGH MENOPAUSE?

Menopause, which commonly strikes women in their late 40s and early 50s, can cause depression, hot flushes, headaches and night sweats. Long term, it can also cause bone disease and memory loss.

Hormone replacement therapy (HRT) tackles these symptoms by replacing the female sex hormones – oestrogen and progestogen – as the body stops producing them.

But while it can transform the lives of many women, studies have shown that there may be an increased risk of breast cancer and heart disease from HRT. As a result, many women no longer accept HRT treatment and some doctors will not prescribe it.

It was however noted by the Woman’s Health Concern (WHC) that one of the American studies used women in their mid-sixties who were often overweight as subjects, and these are unrepresentative of women in the UK.

Furthermore, a controlled trial from Denmark reported in 2012 has demonstrated that healthy women taking combined HRT for 10 years immediately after the menopause had a reduced risk of heart disease and of dying from heart disease, contradicting the reports of the earlier studies.

The WHC says HRT is safe provided it is taken for the correct reasons, i.e. to alleviate the symptoms of the menopause, and at the minimum effective dose. 

Source: WHC 

Researchers were searching for early signs of heart failure, which almost one in five people die from in the first year after diagnosis. 

But they found women on HRT were more likely to have normal-sized heart chambers in their left ventricle and left atrium.

People with early signs of heart failure, in contrast, tend to have enlarged chambers. Their heart muscle is less elastic, their heart pumps less efficiently, and so too much blood is kept in the heart, forcing the chambers to expand.

The effect of menopausal hormone therapy on heart health is still unknown 

Ashleigh Doggett, senior cardiac nurse at the British Heart Foundation

The study, using MRI scans from NHS patients in the UK Biobank database, compared the hearts of women on HRT with those who had gone through the menopause without taking hormones.

They also looked at the mass of the left ventricle, which can predict a higher risk of heart disease and death. But there was no difference between either group of women.

Previous studies on heart disease and HRT have varied in their results, and the treatment has been linked to a greater risk of blood clots.

Ashleigh Doggett, senior cardiac nurse at the British Heart Foundation, which funded the research published in the journal PLOS One, said: ‘The effect of menopausal hormone therapy on heart health is still unknown, with previous research showing both positive and negative effects on the heart.

‘This study adds to our understanding by suggesting that the treatment does have a positive effect on the heart’s structure, which should give reassurance to women taking the treatment.’



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