What is known about the effects of postmenopausal hormones on heart disease?
The estrogen and progestin component of the Women’s Health Initiative, which included over 16,000 women, compared two groups of healthy women (no prior history of heart disease), one using estrogen with progestin and one taking a placebo. In this study, combined estrogen and progestin was associated with a 22 percent increased risk of cardiovascular disease. The incidence of heart attacks increased 29 percent among women taking estrogen and progestin, as compared to the group of women on placebo (106). These effects became apparent after an average of 5.2 years of follow-up. Another randomized trial, the Heart and Estrogen/progestin Replacement Study, recently concluded that estrogen in combination with progestin has no beneficial effects on the heart. Although earlier results from this study had suggested such benefits might exist, longer follow-up (6.8 years) found no overall reduction in the risk of heart attacks and coronary deaths with use of estrogen and progestin (87). Some obse
