LONG-TERM EFFECTS OF HORMONE REPLACEMENT THERAPY ON SYMPTOMS OF ANGINA-PECTORIS, QUALITY-OF-LIFE AND COMPLIANCE IN WOMEN WITH CORONARY-ARTERY DISEASE

Objectives: The aim of the present study was to evaluate the effects o f HRT on symptoms of angina pectoris; quality of life and factors of i mportance for compliance in women with ischemic heart disease. Methods : Sixty postmenopausal women with coronary artery disease were randomi zed into three groups: one group received transdermal 17 beta-estradio l at a dose of 50 mu g per 24 h alone for 18 days followed by 10 days of combined treatment with medroxyprogesterone acetate (MPA) 5 mg oral ly; the second group received placebo and the third group received con jugated estrogens orally for 18 days followed by a combined treatment with MPA for 10 days. Clinical evaluations were performed at baseline, after 3, 6 and 12 months. The investigations included gynecological h istory, occurrence of climacteric symptoms, quality of life evaluation : cardiac history and symptoms of angina pectoris. Results: Forty-six women (77%) completed the study during 1 year. The following cardiac e vents occurred in the women who completed the study: one patient was h ospitalized because of congestive heart failure (patch), two patients because of angina pectoris, one patient because of coronary bypass ope ration (GEE) and three patients underwent balloon dilatation (placebo) , all three on GEE. Among the 14 women who discontinued, two patients had TIA. (patch), one experienced palpitations (GEE) and one woman die d from myocardial infarction (placebo). Overall improvement in mood an d cognitive functions were reported in all three treatment groups. Con clusions: HRT does not seem to have negative effects on symptoms of an gina pectoris and seems to increase quality of life in older women wit h coronary heart disease. It also seems safe from the cardiovascular p oint of view. (C) 1998 Elsevier Science Ireland Ltd. All rights reserv ed.