Dr. Volgman explains if taking hormone replacement therapy (HRT) can be harmful to a woman's heart.
Initially, back in the 1970s and 80s, we thought, or some investigators thought that it was helpful for the heart because what they noticed in observational studies is that right after menopause is when women’s hearts begin to have a lot of problems. Women become most vulnerable for heart disease, heart attacks, strokes after menopause.
So what they postulated was that it was the lack of estrogen after menopause that was helping the woman’s heart. So there were many studies that looked at the effects of hormone replacement therapy, specifically Premarin, to see what it did to cholesterol, and what they found was that it lowered cholesterol, the LDL cholesterol. And so when a woman came to a doctor and they were post menopausal, and they saw a slight increase in the cholesterol, they put them on hormone replacement therapy.
It was like the statins for women, and men got the statins, and guess which one saved lives: the statins. And the hormone replacement therapy, specifically Premarin, was increasing heart attacks and strokes in women.
So, we really did women a disservice so that by 1984, there were more women dying of heart disease than men. There was a huge decline in men’s heart attacks and men dying from heart disease, but in women, it just started to go up. So that by 1999, there were 70,000 more women dying of heart disease than men.
Since we stopped giving hormone replacement therapy because the study showed that we were really increasing heart attacks and strokes by giving them hormone replacement therapy, the number of heart attacks and death from heart disease started to decline in women. But there are still about 40,000 more women dying of heart disease than men, despite the stopping of the hormone replacement therapy.
So, women still are dying more than men from heart disease. And the sad thing is we are starting to see it in younger and younger women. So that we are now seeing heart attacks in women in their 40s and 30s in some women.
About Dr. Volgman, M.D., F.A.C.C.:
Annabelle S. Volgman is associate professor of medicine and medical director of the Heart Center for Women at Rush University Medical Center in Chicago. Dr. Volgman graduated from Barnard College, Columbia University, and received her medical doctorate degree from Columbia University College of Physicians and Surgeons, New York. She received her internal medicine training at the University of Chicago Hospitals and Clinics and her cardiology fellowship training at Northwestern Memorial Hospital in Chicago. She was a fellow in clinical electrophysiology at Northwestern Memorial Hospital and Illinois Masonic Medical Center under Richard Kehoe, M.D.
Dr. Volgman has published numerous abstracts and articles in multiple topics of women and heart disease as well as cardiac electrophysiology. She is currently president of the Metro Chicago Board of Directors of the AHA. She has been a prominent leader of the Go Red for Women movement and has received numerous awards from the American Heart Association. She has been listed in several lists of top doctors and was named a top doctor in the January 2008 issue of “Chicago Magazine.” She has been interviewed by numerous media about health issues and was featured in “O” magazine as Oprah Winfrey’s cardiologist.
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