Hormone replacement therapy after menopause could lower the risk of getting heart diseases, advocates' a new study
OLDER women can also enjoy good cardiac health if they opt for hormone
replacement therapy (HRT) after
menopause, because the hormone
alters the shape of the body giving
the older women more younger and
healthier figures. At the recently held
European Congress on Obesity in
Barcelona, Spain, an Australian
endocrinologist produced striking
evidence that HRT protects the post-
menopausal women from coronary
heart diseases by shifting fat from
around the waist to other parts of
the body where it does less harm.
Katharine Samaras of the Garvan
Institute ofMedical Reseach in Sydney,
Australia, studied 560 post menopausal
women at the Twin Research Unit of
St Thomas's Hospital in London, and
compared the b6dy fat of women
on HRT with those who were not. The
women on the therapy had less body
fat overall but more importantly,
they had nine per cent less fat around
their abdomen. Fat around the
abdomen is a known risk factor for
heart disease. "Our findings suggest
that part of the reduction in heart disease risk in women who use oestrogen
replacement after menopause may
be explained by its a1sociation with
lower amounts of central fat," says
Samaras. The 'apple-shaped' women,
with fat accumulated around the
waist have a higher risk of heart disease,
diabetes and 'hypertension than the
classic 'pear-shaped' women, whose fat
tends to gather around the hips
and thighs.
Mike Lean, professor of human
nutrition at the University of Glasgow
said that women on FIRT return to the
premenopause shape. He suggested the
doctors concerned about patients weigh
them to consider the extent of their
waistline rather than calculate the body
mass index (Bmi), the more usual measure of obesity. BMI is calculated by
dividing weight in kilograms by the
square of the height in metres. "Many
people find it hard to calculate," says
Lean. "So why not use the waist? It correlates better than, or at least as well as,
anything else with breathlessness,
diabetes and bad lipids." He advocates
a simple waist measurement scale for
gauging a patients risk of heart problems. Women should start keeping
an eye on their waist when it reaches
80 cm. Once it reaches 88 cm they
should act urgently, he says. The lower
and upper figures for men are 94 cm
and 102 cm.
According to Kay Tee Khaw, professor of clinical gerontology at the
Addenbrooke's Hospital in Cambridge,
lipids from fat stores around the waist
are mobilised and move into the bloodstream more readily than lipids from
other parts of the body, leading to
increased levels of low molecular weight
lipids. This is the form of cholesterol
that is thought to leave deposits, causing
narrowing of arteries.
The Medical Reseach Council Of
Britain (MRC) has decided to contribute
us $31.5 to an international study to
establish once and for all the risks and
benefits Of HRT. In Britain, 18,000
women will take HRT for 10 years to be
followed up for another 10 years. A
further 16,000 women from other parts
of the world will also participate.
The MRc hopes that the results will
persuade women that the benefits of
HRT - stronger bones and healthier hearts - outweigh slightly
increased risk of breast and endometrial cancers (New Scientist, Vol 50,
No 2030).
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