- A new study finds women on hormone therapy who also take statins may decrease their risk of a serious blood clot.
- These findings may pave the way for new treatment methods for menopause symptoms among women previously thought not to be candidates for hormone therapy.
- Further research is needed to better understand the relationship between statins, hormone therapy, and blood clot risk.
Researchers are learning how statins may help women, who are taking hormone therapy.
Previous studies have found that hormone therapy is linked to a greater risk for serious blood clots called venous thromboembolism (VTE).
Now, a new study published today in JAMA Cardiology explored whether statin use could affect the risk of VTE in women taking hormone therapy.
The study looked at women over age 50 who are taking hormone therapy. It found women, who did not take statins, had a higher risk of developing VTE compared to women who took statins along with hormone therapy.
“About a decade ago, we started noticing in some large clinical trials that statins – which are used for preventing all sorts of cardiovascular diseases, such as heart attacks and strokes – also seemed to reduce risk of VTE,” Susan C. Weller, PhD, a Professor in the Department of Population Health, in the School of Public and Population Health at the University of Texas Medical Branch, Galveston, Texas told Healthline. “In our study, we wanted to explore whether that same association was present in perimenopausal women, with and without hormone therapy. Using a large health insurance database, we found that statins were indeed associated with significant, meaningful reductions in risk for a VTE.”
Fewer women on statins developed serious blood clots
Researchers looked at VTE risk in 223,949 women taking hormone therapy between the ages of 50 to 64 with or without statins. The women were separated into four groups:
- 16,350 women taking hormones without a statin
- 3,208 women taking hormones with a statin
- 33,030 women taking statins without hormones
- A control group of 171,361 women who did not take hormones or statins
Whether or not they also took statins, women on hormone therapy were at higher risk of developing VTE than the control group of women who did not take hormones or statins.
However, the women who took hormones but did not take statins had the highest risk of developing VTE. In those women, the risk of developing VTE was 53% higher than the control group of women who did not take statins or hormones.
Women who took both statins and hormones had a 25% higher risk of developing VTE compared to the control group.
This indicates that statins are associated with a reduced risk of VTE among women taking hormone therapy.
Could statins help more women get better treatment for menopause?
Experts say this study could lead to more women getting hormone therapy.
“We know that menopausal hormone therapy is a powerful tool for controlling menopause symptoms, such as hot flashes and vaginal dryness,” said Weller. “However, menopausal and perimenopausal women have been told for decades (since some very large trials in the late 90s/early 2000s) that menopausal [hormone therapy] may be too dangerous to take.”
Weller said after those clinical trials found women on hormone therapy at higher risk for VTE, many women have avoided the treatment. As a result, women may be dealing with serious symptoms of menopause rather than finding relief through hormone therapy, Weller said.
Weller also pointed out that women on high intensity statins had an even lower risk of VTE.
“VTE and other adverse effects have limited more widespread adoption of hormone therapy (HT) for menopausal symptoms in women, and posed risks to the women who have pursued [hormone therapy,]” said Dr. Leonard Ganz, chief medical officer and divisional vice president of medical affairs at Abbott’s cardiac rhythm management business. “If risks of VTE in this setting are mitigated by statins, widely used medications to mitigate risks of cardiovascular disease, it could potentially make [hormone therapy] a safer therapy in menopausal women.”
Ganz was not involved in the study.
Ganz continued: “While study designs like this can never prove causality, the fact that the beneficial effect was more prominent in women taking high intensity statins compared with low and moderate-intensity statin therapy is quite encouraging.”
“We are finally chipping away at the stigma of menopause and exploring innovative ways to care for women experiencing bothersome menopause symptoms,” said Dr. Mary Rosser, assistant professor of women’s health and Director of Integrated Women’s Health at Columbia University Vagelos College of Physicians and Surgeons. “A woman’s quality of life can be jeopardized but can be effectively relieved with [hormone therapy].”
Rosser was not involved in the study.
Rosser noted: “This opens many avenues for treatment of menopause symptoms in more women, previously thought NOT to be candidates for [hormone therapy,] an effective reliever of menopause-associated symptoms.”
More research is needed to understand if statins lead to less risk
Weller said the study may help many women feel they can take both hormone therapy and statins, but she cautioned more studies will be needed in the future.
Other experts point out that more research is required to understand if statins themselves cause fewer blood clots or if there are other reasons that the specific group is at lower risk for blood clots.
“Statins are increasingly used in primary prevention, with use in those with lower risk,” Dr. Rohan Khera, assistant professor of medicine in the section of cardiovascular medicine at the Yale School of Medicine and of Biostatistics in the Section on Health Informatics at the Yale School of Public Health, stated. “Statin users who take [hormone therapy] may be a lower-risk population than the broader population of statin users who also include those with cardiovascular disease. These considerations become key in evaluating the study’s results and whether they somehow confounded the observations.”
Khera was not involved in the study.
The other end of the spectrum is that those who are not on statins but receive hormone therapy are not those expected to be at a higher risk. So, there is no clear directional bias per se, Khera explained.
Khera warned against overinterpreting the study since the data was from insurance companies and that more data is needed to prove causality.
“For example, it is not clear whether statin users on [hormone therapy] were generally more engaged with healthcare and therefore were on preventive therapy.”
“I would caution that there cannot be a treatment recommendation drawn from this study. The study still needs to be confirmed in a trial,” said Khera. “The effect sizes are large, and I wonder if some of that suggests the effect of unmeasured features in the statin vs the control arm. A single claims-based analysis is not good enough to feature in evidence-based risk-benefit calculus of [hormone therapy] and statin use.”
Takeaway
A new study shows the risk of serious blood clots was 53% higher in women recently exposed to hormone therapy without statins. For women with statins the risk was 25% higher for women with statins. These findings suggest that there is an association between statins and a reduced risk of VTE among women taking hormone therapy.
The results from this study may begin to inspire new approaches for treatment regarding menopause symptoms among women were not considered candidates for HT.
To further understand the connection between statins, hormone therapy, and VTE, more studies are necessary.
For Women on Hormone Therapy, Stains May Help Lower Blood Clot Risk
Source: Pinoy Lang Sakalam
0 (mga) komento:
Mag-post ng isang Komento