Two new studies in prestigious journals cast doubt on the long-term benefits of hormone replacement therapy (HRT) for bone and heart health.

The Journal of the American Medical Association ( JAMA 6/13/01) published a review of 22 randomized trials of estrogen replacement. Researchers found a positive relationship between estrogen therapy and healthy bones in women under 60 years old, but no benefits after the age of 60.

"Until the effectiveness of estrogen is clarified, treatments other than estrogen therapy should be the first choice for older women." JAMA concluded in an accompanying editorial.

A study on HRT and cardiovascular health, reported in the Annals of Internal Medicine (7/3/01), was in some ways more alarming. Researchers looked at the histories of 2,489 postmenopausal women with previous heart problems who were participants in the well-known Nurses' Health Study. They documented a 52% higher risk of major coronary events during the first year of HRT use than in women not assigned to hormone therapy.

After 4-5 years of HRT, there was a positive association between HRT and heart health in 33% of the women who received estrogen. The researchers concluded that HRT should not be recommended soley for cardiovascular reasons.

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