CHAPEL HILL -- Postmenopausal women smokers from both rural and urban areas are being sought for a University of North Carolina at Chapel Hill School of Medicine study of hormone replacement therapy.
Healthy volunteers ages 45 to 70 who have not had a menstrual period in nine months and who are not taking estrogen may qualify for the study, which will offer $450, up to $150 more in travel expenses, free medical tests including mammograms and free hormone treatment. Some study visits will take place at UNC-CH, while the rest will be at local health departments.
"Hormone replacement therapy is simply giving back to postmenopausal women estrogen and progesterone, which are naturally occurring," said Dr. Susan S. Girdler, assistant professor of psychiatry and study director. "After menopause, women's bodies stop producing these hormones, which help protect them from osteoporosis and heart disease."
Volunteers from rural areas are being recruited because women -- especially those from outside cities and towns -- have been under-represented in past studies of heart disease, Girdler said. No previous researchers have looked at estrogen replacement in women who smoke except in observational studies not considered definitive but which suggest smokers might benefit the most.
For information about registering, call project nurse coordinator Linda Anderson at 919-966-2547.
Cardiovascular disease includes heart disease, stroke and high blood pressure.
"Although men suffer from cardiovascular disease at a rate of three to six times that of premenopausal women, after menopause when estrogen production is reduced, the risk of cardiovascular death for women climbs to almost the same level as men," Girdler said. "Cardiovascular diseases are the leading cause of death for both men and women, killing twice as many women each year as all cancers combined."
A Boston study of more than 120,000 U.S. nurses indicated that receiving estrogen after menopause might cut the heart attack risk in half for women in general, she said. Many doctors decline to give estrogen to postmenopausal women who smoke, however, because of outdated research showing possible harmful effects in smokers from certain discontinued oral contraceptives high in estrogen.
The UNC-CH researchers are conducting their study to learn whether women smokers, who are at increased risk of cardiovascular disease, could benefit even more than nonsmokers from supplemental estrogen, as the recent less-well-controlled observational studies suggest. They also hope to learn whether it's more beneficial to receive estrogen by mouth or by skin patch.
"This is an exciting decade for both researchers and study participants because it's only been since 1993 that biomedical research has focused strongly on women's health issues," Girdler said. "Health departments, and rural health departments in particular, have been wonderful in cooperating so that we can minimize the number of trips rural women have to make to Chapel Hill to participate."
The National Heart, Lung and Blood Institute is supporting the four-year, placebo-controlled study, which also will provide free gynecological exams, 24-hour blood pressure testing with a portable monitor, ultrasound heart examinations and cholesterol profiles. Scientists also will look at factors known to influence heart disease such as income, differences in support from families and friends and access to health care.
Note: Girdler can be reached at 919-966-2544.
Contact: David Williamson, 919-962-8596.