Women ‘can be given HRT’ despite high blood pressure

DOCTORS should stop denying menopausal women HRT j ust because they have high blood pressure, say experts.

Thousands of women are thought to have been unfairly excluded from using hormone replacement therapy because GPs worry the drug might raise the risk of heart problems – despite complaints from specialists.

But the National Institute for Health and Care Excellence (Nice) in England has now announced it is considering publishing official advice on the issue following research that found women who start taking HRT in their 50s may actually have a reduced risk of heart disease.

Nice, which gives doctors up-todate medical advice, said GPs and specialists should no longer rule HRT out by default.

It will carry out a public consultation before issuing final advice later this year.

In a statement yesterday it said: ‘It is often considered that women at risk of hypertension (high blood pressure) or other cardiovascular conditions should not take HRT – but the draft recommendations propose that they shouldn’t automatically be prevented from taking it.’

Nice advises that menopausal women should now be told HRT does not necessarily increase the risk of heart problems or stroke – and that in some cases actively reduces it.

Common symptoms of the menopause include hot flushes, night sweats, mood c hanges a nd stiffness.

It can also lead to brittle bone disease and memory loss. HRT, taken by one million British women at any one time, reduces these symptoms by artificially providing oestrogen as the body stops making it.

But many doctors have been reluctant to prescribe it since a major study in the United States in 2002 raised fears about the possible side effects.

However, expert analysis has since concluded the study was flawed.

The latest research, which was published this year, found that in women under 60 – or for those who started HRT within ten years of the menopause – there was a 30 per cent drop in deaths from any cause and a 48 per cent lower risk of coronary heart disease.

Experts have welcomed the new approach, saying i t was ‘ l ong overdue’.

London-based consultant metabolic physician Dr John Stevenson said: ‘ If you have hypertension you cannot afford to be without oestrogen, because a lack of oestrogen is one of the risk factors for cardiovascular disease.’

Nice’s clinical practice director, Professor Mark Baker, said yesterday: ‘Menopause symptoms can severely upset a woman’s day to day life.

‘Nice is pleased to be developing the first guideline for the NHS on diagnosing and managing menopause, to help improve the lives of women affected by it.’