One Study Shows Estrogen May Lower Risk for Heart Disease; Another Says It Could Increase Risk

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Taking estrogen decreases the risk of heart disease slightly in post-menopausal women with diabetes, say researchers in New Zealand. Patrick J. Manning, MBChB, and colleagues, from the departments of medicine at the University of Otago in Dunedin, New Zealand, demonstrated positive changes in the blood cholesterol and blood-clotting factors of middle-aged women with diabetes when they were given hormone replacement therapy. Findings were published in the July 23 issue of the Archives of Internal Medicine.

In a randomized, controlled, crossover study, 61 women were given continuous hormone replacement therapy or a placebo, in increments of six months, with an eight-week washout period between the treatments. Cholesterol, blood-clotting and glucose levels were measured before and after the treatment.

During the treatment, total cholesterol concentrations decreased by seven percent; LDL (bad) cholesterol decreased by 12 percent; and lipoprotein A decreased by 21 percent. Also, concentrations of fibrinogen (a blood-clotting factor) decreased by eight percent, and fructosamine concentrations (a short-term measure of average glucose control) decreased by five percent.

Hormone replacement therapy “has beneficial effects” on these “markers” for heart disease, conclude the researchers.

It is also being suggested that estrogen increases a woman’s chance of getting microalbuminuria, or increased levels of albumin—protein in the urine—say researchers in Holland.

Microalbuminuria, a risk factor for both kidney and heart disease, was found in women who took birth control pills (before menopause) and in those who took hormone replacement therapy (after menopause). Also, people with diabetes are at higher risk for kidney and heart disease. Wilbert M. T. Janssen and colleagues, from the University of Groningen, Holland, published these findings in the September 10 issue of the Archives of Internal Medicine.

Researchers studied the levels of microalbuminuria in 3,305 women ages 28 to 75 who participated in the Prevention of Renal and Vascular End Stage Disease Study.

Researchers said the use of birth control pills increased the women’s chance of having microalbuminuria by 90 percent, according to Reuters Medical News. Those who took hormone replacement therapy doubled their risk of getting microalbuminuria. In addition, those who took hormone replacement therapy for five years or more had a higher chance of developing high levels of the protein than those who took it for less than five years.

Women who take estrogen “may have an increased risk” for heart disease and attendant death, researchers conclude. However, researchers also point out that further studies need to be done.

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