Health risks persist after HT is stopped

Women who stop taking estrogen plus progestin no longer have an increased risk of cardiovascular events, when compared to women who never received hormone therapy. But they may have an elevated risk of developing fatal and non-fatal malignancies, researchers report in the March 5 issue of the Journal of the American Medical Association.

Gerardo Heiss, MD, of the University of North Carolina in Chapel Hill, and colleagues compared health outcomes in 15,730 women who were included in the postintervention phase of the Women’s Health Initiative that began on July 8, 2002.

After a mean 2.4 years of follow-up, the researchers found no significant difference in the annualized rate of cardiovascular events in women who had previously received hormone therapy and women who had received placebo (1.97% vs. 1.91%, respectively). But they found that the hormone therapy group had significantly higher risks of malignancies (HR, 1.24) and breast cancers (HR, 1.27), and a somewhat higher risk of all-cause mortality (HR, 1.15). The researchers also found that overall risks outweighed the benefits of hormone therapy, with a global risk 12% higher compared to the placebo.

“Following termination of use of conjugated equine estrogens plus medroxyprogesterone acetate of 3.5 to 8.5 years, clinical vigilance seems warranted with respect to a sustained higher risk of malignancies,” the authors conclude.

Heiss G, Wallace R, Anderson GL. Health risks and benefits 3 years after stopping randomized treatment with estrogen and progestin. JAMA. 2008;299:1036-1045.