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Postmenopausal women who took combination hormone therapy did not have a lower risk of coronary heart disease during the first two years of treatment, according to an article in the Feb. 16 Annals of Internal Medicine.

When considering whether to prescribe estrogen plus progestin hormone therapy, study author Sengwee Darren Toh, ScD, suggests that physicians use the lowest dose that helps for the shortest duration possible. That approach is consistent with the Food and Drug Administration's recommendation.

"Coronary heart disease is one of many outcomes [physicians] should consider when initiating hormone therapy," said Toh, an instructor in the Dept. of Population Medicine at Harvard Medical School in Boston and Harvard Pilgrim Health Care Institute, an affiliate of the school.

Researchers analyzed the short-term effects of the combination treatment on coronary heart disease using data from 16,608 postmenopausal women ages 50 to 79 with an intact uterus at baseline. The women participated in the Women's Health Initiative Estrogen plus Progestin study from 1993 to 1998.

Of the participants, 8,506 received a daily hormone regimen of .625 mg of conjugated equine estrogens plus 2.5 mg of medroxyprogesterone acetate. The other 8,102 received a placebo.

During the first two years of treatment, there were 80 cases of coronary heart disease for women who took the combination therapy. There were 51 cases among women who received a placebo (www.annals.org/content/152/4/211.abstract).

Toh said the study shows that the duration of time a woman takes hormone therapy, not just when she starts treatment, should be considered when determining how combination hormone therapy affects coronary heart disease.

The full and original article can be found here: http://www.ama-assn.org/amednews/2010/02/22/prsc0223.htm

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