Dallas The influential American Heart Assn. is changing course and recommending that women not be prescribed estrogen solely to prevent strokes and heart disease, because of growing evidence that the supplements might cause harm.
Doctors long believed that hormone supplements are good for women's hearts. But the heart association one of the most authoritative organizations in the field of heart disease prevention cited conflicting evidence that has come out over the past few years.
Hormone supplements combining estrogen and progesterone are prescribed to about 20 million American women, mostly to treat hot flashes and other post-menopausal symptoms and to lower the risk of brittle bones.
The heart association said that women taking hormones for the non-cardiac benefits do not need to stop. But women should not start taking hormones simply to prevent heart trouble.
The new guidelines were published in today's issue of Circulation, a journal of the American Heart Assn. They represent a shift from 1999, when the organization said that doctors may consider the use of hormones to help prevent heart disease.
The lead author of the guidelines, Dr. Lori Mosca, director of preventive cardiology at New York Presbyterian Hospital of Columbia and Cornell universities, said the widely held assumption that estrogen offers a protective effect is based on the fact that women generally have their first heart attack 10 years later than men.
But a review of research on the topic found no clear evidence that hormone replacement therapy reduces the risk of heart disease in women, and actually found that in some cases, women had a higher risk of heart problems, Mosca said.