New WHI data on younger women is more reassuring

A recent study finds that estrogen takers between the ages of 50 and 59 have less calcified plaque in their coronary arteries and a lower prevalence of subclinical coronary artery disease than estrogen abstainers.

In an ancillary substudy of the Women's Health Initiative Trial, women between the ages of 50 and 59 who had already undergone hysterectomy received either 0.625 mg/day conjugated equine estrogens or placebo and were followed with computed tomography of the heart for up to 8.5 years.

The mean coronary-artery calcium score at the end of the trial was about one third lower in the group of women taking estrogen than in the group taking placebo (83.1 vs. 123.1, respectively; P=0.02). In fact, the estrogen group had both a lower prevalence and a lower quantity of coronary-artery calcium than the women in the placebo group. Their odds ratios for high levels of coronary-artery calcium were generally 30% to 40% lower in intention-to-treat analyses and up to 60% lower in women with at least 80% adherence to the study protocol for at least 5 years.

Manson JE, Allison MA, Rossouw JE, et al. Estrogen therapy and coronary-artery calcification. N Engl J Med. 2007;356:2591-2602.