First heart attacks and deaths from heart attacks are lumped together as though they were the same thing. One must immediately wonder why the researchers found it necessary to do this, since a heart attack and dying from a heart attack are not the same thing.

There is no breakdown of how many of the study participants on hormones were taking estrogen alone and how many were taking estrogen and a progestin, yet we know that progestins negate most of the improvement in blood lipids that estrogen seemingly provides. Again the reader must question why the distinction isn't made in the results since intact women must take a progestin or a progesterone to prevent the ten-fold increase in endometrial cancer which estrogen alone will cause. [2001 Recent studies show increase in breast cancer risk over the risk already seen from estrogen - Tishy]

There is no evidence that progestins are safe for long term use and they have never been approved for either long term use or to protect the endometrium from the effects of estrogen. There is no evidence that progesterone will protect the endometrium, and its long term safety has also never been shown. If only 10% of the women were taking estrogen *and* progestin, then the results are almost worthless for intact women who must take the progestin component. There are studies in animals which suggest that progestin increases the likelihood that a heart attack will be fatal. 

The raw numbers themselves show the real weakness of this study. Over a ten year period there were 134 fewer heart attacks in the group that took hormones of any kind - out of a total study population of 48000 women. 13 heart attacks or deaths from heart attack prevented each year. The number is too small to be of any clinical significance, yet the 50% statistic is repeated endlessly. There is no evidence that this number will hold up in the decades ahead when heart disease becomes a bigger problem as the study participants age, and some suggestion that it will not. 

Breast cancer risk increases with age and with the length of time hormones are used. The increase is 45% in women 50-59, 71% in women 60-64, and unknown in women over 64. All of these numbers are after only five years of hormone use. Progestins seem to increase the risk of breast cancer further. Admittedly the numbers of women who develop breast cancer from hormone use is also small at this time, but the trend is upward with age and duration of use. 

Any suggestion that hormones will prevent Alzheimer's is premature. The evidence simply isn't there. But there is evidence that Wyeth Ayerst, makers of premarin, premphase, and prempro among others are using the Alzheimer's issue in an attempt to defuse the breast cancer risk which is becoming more apparent with every passing year. See Dr. Susan Love's Hormone Book for the cite. Read Dr. Love's book for a balanced discussion of hormone use, its risks, its benefits,and a good evaluation of the studies conducted so far.