Thursday, October 11, 2012

HRT 'is safe and can protect against heart without increasing cancer risks'

This was evident from the beginning.  It was only attention-seeking hysteria that knocked it

Taking HRT is safe and can protect against heart disease without increasing cancer risks, a milestone study claims.

It found women who take hormone replacement therapy at the start of the menopause for 10 years can reduce their risk of heart failure, heart attacks and premature death.

Most importantly, the study found there was no extra risk of cancer, strokes or blood clots even 16 years after starting HRT.

Using HRT halved the risk of heart disease and strokes, and cut the death rate by 43 per cent during the study period.

Experts hailed the findings as finally demonstrating that HRT has long-term health benefits after a decade-long controversy over its safety.

British doctors are calling for rules on HRT prescribing to be re-written, allowing a new generation of women to get bone protection and relief from menopausal symptoms such as hot flushes and mood changes.

At present, women in their 50s are told to use hormone replacement therapy drugs for the shortest period of time and not longer than five years.

The new Danish study is the only one to be carried out where women were randomly assigned to take HRT at the start of the menopause, and then their health checked after ten and 16 years.

Around 1,000 aged between 45 and 58 were recruited, with half taking HRT which was started early after the menopause. The control group received no treatment.

The study, published on the website, found that after ten years, 33 women in the control group had died or suffered heart failure or a heart attack compared with only 16 women who were given HRT.

They also found that 36 women in the HRT group were treated for cancer compared with 39 in the control group. Ten women in the HRT group were treated for breast cancer compared with 17 in the control group. Eleven women in the HRT group were treated for strokes compared with 14 in the control group.

Specialists had long believed the oestrogen in HRT should prevent heart disease, but in 2002 the US Women’s Health Initiative study claimed women on the treatment were at higher risk of breast cancer, heart disease and strokes.

Expert analysis has since concluded the risks were caused by HRT being used in women many years past the menopause, for whom it was never intended.

Dr John Stevenson, reader in metabolic medicine at Imperial College London, said UK authorities should update guidance which says HRT should be offered only to women with serious menopausal symptoms for the shortest time possible.

‘The strength of the [Danish] study is its long duration, and this shows that HRT, started around the menopause, is really pretty safe indeed, even for longer-term use,’ he said.


Botox trialled as asthma treatment

An oddball idea but it is fair to give it a trial

A Melbourne research team is hoping it can help fight asthma by using Botox which is commonly used to reduce wrinkles.

The researchers are reporting promising results from injections of Botox into the voice box.

They will also trial using Botox to treat hay fever.

Yvonne Lakeland is one of a group of asthma patients who have undergone the new treatment involving the Botox injection. She has had severe asthma for decades and has suffered many asthma attacks.  "There were times where I've had to be resuscitated and I've been on life support," she said.

The trial is being led by the director of respiratory medicine at the Monash Medical Centre in Melbourne, Professor Phil Bardin.

"In 11 injections we've given, nine we think have been successful," he said.  "What it's done is it's improved people's asthma symptoms - hasn't taken the asthma away obviously but seems to have improved it in many people.

"On the measurements we do on the CT scan, we can see that there's an opening of the voice box that suggests that more air is going through and suggests that people will be feeling less breathless with their asthma."

Professor Bardin says in asthmatics it is believed the voice box is asthmatic as well as the lung itself and that some of the limited air flow is caused by the voice box blocking the flow of air to the lung.

"So all the treatment does is it causes paralysis, or partial paralysis," he said.  "Some of the muscles in the voice box it relaxes and lets air through, in and out."

Despite the promising signs, Professor Bardin does not have enough proof that Botox can combat asthma but is planning a more comprehensive trial to find out.

Ms Lakeland is optimistic.  She had five asthma attacks last year and has noticed an improvement since her Botox injections. "In February this year I had the first injection," she said. "It's over four months now since I had the last one, which was only the second one and I still haven't had an attack.  "That's good news".

It is not the first time the botulinum toxin has been used in medicine.  It is used in neurology and as a treatment for migraines.

A comprehensive trial of the asthma treatment will begin next year.

Professor Bardin is hoping it can also be used to target the nerves responsible for hay fever.  "It will get under the surface, below the surface, and will be able to have an effect there," he said.  "It may be much more effective than say treatments with antihistamines that try to mop up the problem after it's occurred."

Professor Bardin is about to begin a trial of a gel to treat hay fever.


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