Cholesterol indicates if HRT would be heart-safe

NEW YORK (Reuters Health) - For women going through menopause and considering hormone replacement therapy (HRT), their cholesterol levels can indicate the likely risk to their heart health, researchers report.

"Because studies on hormone therapy have shown that they may increase heart attacks and strokes, many women have been reluctant to use this treatment," Dr. Paul F. Bray, from Jefferson Medical College in Philadelphia, said in a statement. "We found that a simple and widely used blood test may be useful to advise women if they are at an increased risk of a heart attack while undergoing hormone therapy."

The team analyzed data from the Women's Health Initiative hormone trials for 271 women who developed coronary heart disease and 707 women without heart disease.

As reported in the American Journal of Cardiology, women whose ratio of LDL ("bad") cholesterol to HDL ("good") cholesterol came to less than 2.5 had no increased risk of a heart attack or angina while using estrogen alone or with progesterone. By contrast, a ratio of 2.5 or higher was associated with a 73 percent higher likelihood of heart-related illness.

While the results suggest that the LDL/HDL ratio is useful in predicting coronary risk in women starting hormone therapy, there is no evidence that it helps predict the risk of stroke, Bray emphasized.

Moreover, he added, hormone therapy has been linked with a number of other conditions, such as blood clots and breast cancer, and the LDL/HDL ratio is unlikely to be useful for predicting those conditions.

SOURCE: American Journal of Cardiology, for June 1, 2008.