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Slight rise in heart problems found in estrogen study WASHINGTON (April 4, 2000 1:30 p.m. EDT http://www.nandotimes.com) - Older women taking estrogen in one of the nation's largest medical studies were slightly more likely to suffer heart attacks, strokes or blood clots during their first two years of treatment compared with women who took a placebo, according to preliminary findings. The findings are preliminary and the risk was very small - in fact, it seems to go away after the first two years of hormone use. But the preliminary findings add to growing questions about estrogen's effect on the heart. Two other recent studies found no evidence estrogen helped the hearts of postmenopausal women who already have heart disease. Yet the hope behind estrogen was not that it could help existing heart disease but that it could prevent or delay it, something the Women's Health Initiative is studying. And experts stressed Tuesday that it is too early to change how women and their doctors decide who should try estrogen - already a complex decision. An estimated 16 million postmenopausal women already take hormone replacement therapy, either estrogen alone or combined with progestin. Hormone replacement can reduce menopausal symptoms, such as hot flashes and vaginal dryness and can reduce the risk of osteoporosis. Some previous studies suggested it reduced the risk of heart disease, and it is being studied as possible protection against Alzheimer's disease. But it also can increase the risk of breast cancer. "We don't know how this is going to play out," cautioned Elizabeth Ross of the American Heart Association. "I don't think there's anything here to make us change our clinical practice. ... It's a patient-to-patient decision." The initiative is a huge, federally sponsored study of women's health issues, and 27,000 women are participating in the hormone-therapy portion. Those women all were mailed letters Friday notifying them of the preliminary findings. Only a little more than 1 percent of the 27,000 participants have suffered either a heart attack, stroke or blood clot regardless of whether they were given hormones or a placebo, said the initiative's acting director, Jacques E. Rossouw. But the frequency of these health problems was slightly higher in hormone-treated women than placebo-treated women, Rossouw said, although he refused to provide actual figures. The initial increased risk "seems to go away" after the first two years of hormone treatment, Rossouw said. But he cautioned that the study isn't slated to end until 2005, so results could change. Another recent study of estrogen in heart-disease patients also found the first two years of treatment posed a heart attack risk that decreased with longer hormone use. Although estrogen has long been known to cause blood clots, "these findings for heart attacks and strokes were not expected ... when you first jointed this landmark study," say letters to the participants. However, independent safety monitors concluded the study should continue, and the letters urged women not to withdraw. "We really owe it to the public out there to continue so we have definitive answers," Rossouw said. Copyright 2000 Nando Media Copyright 2000 Associated Press <http://www.nandotimes.com/noframes/story/0,2107,500188877-500253744-501291186-0,00.html> janet paterson 53 now / 41 dx / 37 onset a new voice: http://www.geocities.com/janet313/ 613 256 8340 PO Box 171 Almonte Ontario Canada K0A 1A0