Mature Focus: News and Notes — Taking hormone therapy to heart

Taking hormone therapy to heart

A new analysis of the Women’s Health Initiative (WHI) trials shows that women who had metabolic syndrome before starting hormone therapy had a greatly increased risk of heart attack or dying from heart disease, according to the North American Menopause Society (NAMS).

Launched in 1991, the WHI trials involved more than 161,000 postmenopausal women and were designed to test the effects of postmenopausal hormone therapy and other variables on heart disease, fractures, and breast and colorectal cancers.

Findings of the new analysis, recently published in the NAMS journal, Menopause, “emphasize the importance of assessing cardiovascular disease risk status when hormone therapy is considered for relief of menopausal symptoms,” according to WHI investigators.

For the analysis, participants were considered to have metabolic syndrome if they had any three of the following symptoms: large waistline (central obesity); high blood pressure; high blood glucose or diabetes; high triglycerides; and low HDL (the “good” cholesterol).

Women who did not have metabolic syndrome showed no increased risk of heart disease, regardless of whether they took hormones, but the risk of a heart attack or death from heart disease was more than double for women who had metabolic syndrome and took combined estrogen-progestogen. The increased risk was smaller for women with metabolic syndrome who took estrogen alone but also was significantly higher than for women with metabolic syndrome who did not take hormones.

Women in the WHI trials took oral hormone therapy as opposed to the smaller doses and skin patches and gels being used today, and they averaged 66 years of age, which is older than the age women typically start hormone therapy to manage menopause symptoms.

While newer forms and earlier use of hormone therapy may be safer, more study is needed to find out if having metabolic syndrome makes a difference with the newer types of hormone therapy, researchers said.

 

Baby boomers’ health interest peaks at 51

For members of the baby boom generation, an interest in health issues usually peaks at about age 51 and peaks again around age 65, according to a study conducted at Ohio State University.

Ohio State researchers wanted to gauge baby boomers’ interest in health so medical professionals would know the best time to target health information to Americans born between the mid-1940s and mid-1960s. Their study was based on a survey of 477 adults aged 45-65 who were asked to rank the level of importance of 18 health issues, including diabetes, cancer, heart disease, arthritis, and nutrition and weight management.

Results showed that people in their late 40s were the least interested in health issues, but interest rose quickly after that and peaked in the early 50s. Then the interest level dropped slightly and leveled off for the rest of the 50s and early 60s, but a second peak occurred near age 65.

“The early 50s are clearly a key change point for the baby boomers we studied,” Katey Price, a member of the research team, said in an Ohio State University news release. “This would be a great time to reach boomers with messages about how to improve and protect themselves.”

Researchers said they could find no medical reason to explain the reason for the peaks at ages 50 and 65. They said they suspected that information the media and health professionals provide to people at age 50 accounts for the peak in interest at that age.

“Fifty is the age Americans are told they need to undergo a variety of health screenings,” said John Dimmick, lead author of the study. “For example, people are often told that they should get a colonoscopy, mammogram and – until recently – a PSA test for prostate cancer when they turn 50.

“People start really paying attention to their health when they are encouraged to get all of these screening tests.”

The second peak, they said, probably comes around retirement age, when people are likely to begin thinking of themselves as old.

“Age 65 is when people traditionally are thought of as senior citizens,” Price said. “Old age is synonymous with declining health in our culture, so people again start thinking they should be worried about their health.”

The survey also asked respondents where they obtained their health information. The No.1 source of health information reported was health professionals, and the media – particularly the Internet – came in second.

Respondents rated as relatively high in importance seven of the 18 health issues listed on the survey: eyes, diabetes, cancer, heart disease, nutrition/weight management, arthritis and high blood pressure.

 

Boosting brain power

Leading an active lifestyle helps preserve gray matter in older adults’ brains and slows the progress of dementia, according to a study recently presented at Radiological Society of North America’s annual meeting.

Researchers at the University of California in Los Angeles examined the influence of an active lifestyle on brain structure by looking at two decades of data on 876 adults with an average age of 78 years. Lifestyle factors examined included recreational sports, gardening and yard work, bicycling, dancing and riding an exercise bike.

Researchers used magnetic resonance imaging (MRI) and advanced computer technology to study the relationship between active lifestyle and gray matter volume. Greater caloric expenditure was related to larger gray matter volumes in areas of the brain that are crucial for cognitive function.

“Gray matter volume is a key marker of brain health. Larger gray matter volume means a healthier brain. Shrinking volume is seen in Alzheimer’s disease,” said Cyrus Raji, M.D., a radiologist who worked on the study. “What struck me most about the study results is that it is not one but a combination of lifestyle choices and activities that benefit the brain.”

Raji said the positive impact of an active lifestyle on the brain likely is due to improved vascular health, because all activities examined were aerobic in nature.

“Additional work needs to be done; however, our initial results show that brain aging can be alleviated through an active lifestyle,” he said.