For many years it has been assumed that loss of the protective effects of estrogen was responsible for the greater risk of heart attacks and dying in postmenopausal women. A 2011 publication in the British Medical Journal by researchers at Johns Hopkins questions the validity of this assumption. Let's look at why this is.
Number of Deaths Did Not Increase beyond Those Expected from Aging
The investigators examined changes with age in the mortality rates from coronary heart disease (CHD) using census data. They drew from census years 1950 to 2000 for men and women born between 1916 and 1945 in England, Wales, and the United States. Rather than showing an abrupt rise after the menopause, CHD mortality rates in women progressed at a constant rate as they aged. Stated another way, female CHD mortality rates did not increase beyond the expected numbers from aging. The authors of the study believe that “the cells of the heart and arteries are aging like every other tissue in the body, and that is why we see more and more heart attacks every year as women age.”
Other Findings of the Study
The findings also raised questions regarding the long held belief that the lack of estrogen in young men was responsible for their higher mortality from CHD compared with young women.
In addition, the results showed lower lifetime mortality from CHD among both men and women born in later years, coinciding with other evidence for an overall decline in deaths from CHD over time. Such findings reinforce the value of preventive care through lifestyle measures and medications as well as better treatment of CHD.
Failure of Estrogen Replacement in Postmenopausal Women to Protect Against CHD
The study results are also consistent with the trials which showed that postmenopausal hormone replacement did not diminish mortality from CHD.
Take Home Message
It’s most important for women to recognize that CHD, not breast cancer, is their greatest health threat. Moreover, it is clear that preventive measures are effective for women as well as men.