Early HRT Protects a Woman's Heart

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The findings were not consistent with those of the Women's Health Initiative, leading NHLBI cardiologist and study co-author Dr. George Sopko to say, "I'm somewhat surprised by that. In our cohort, many -- if not most -- of these women had uninterrupted hormonal status. There was not a gap between the decline of reproductive hormone levels and the start of replacement therapy, and maybe that is one of the key elements."

Oral contraceptives are one of the most frequently used drugs in the world with 100 million women taking them, yet there is not nearly as much heart research into contraceptives as there is into HRT.

This Belgian study found a 20 percent to 30 percent increased prevalence of plaque in the carotid and femoral arteries for every 10 years of exposure to oral contraceptives.

Does this mean women should be wary of taking the pill?

"That is a question for a philosopher, not a physician," said study lead author Dr. Ernst Rietzschel, of Ghent University's department of cardiovascular disease and public health. "We don't prescribe oral contraceptives so women will live longer. Women take them, because they want contraceptives, and contraceptives have been an enormous force for a lot of women to fulfill their rightful role in society. I believe the options should stay open, maybe not for very long time frames."

Two additional studies presented Tuesday found gender differences in how women "present" with heart disease and how they respond to treatment.

The first study found that two risk factors -- smoking and family history -- are associated with presenting with STEMI (ST-segment-elevated myocardial infarction) at an earlier age for women. In general, women tend to manifest coronary artery disease about a decade later than men.

"The most striking relationship we found was that with cigarette smoking. So, women who did not smoke had an average age of 71, whereas the average age of presentation in women who do smoke or had a history of smoking was 62," said study lead author Dr. William Herzog, of Johns Hopkins Medical Institutions, in Baltimore.