Study Shows Lifestyle Changes Are Effective for Reducing Cardiovascular Disease Risk Factors

When Discontinuing Hormone Replacement Therapy


San Diego, May 15, 2007 – Hormone replacement therapy (HRT) has been shown to reduce many cardiovascular disease (CVD) risk factors, but many women have stopped using HRT due to reports from the Women’s Health Initiative that HRT may increase the risk of breast cancer and heart disease. In a study published in the June issue of the American Journal of Preventive Medicine, researchers from the University of Pittsburgh Graduate School of Public Health examined whether the increased CVD risk from stopping HRT could be minimized by lifestyle change intervention.

Participants were part of the five-year Women On the Move through Activity and Nutrition (WOMAN) study, a randomized clinical trial of CVD prevention. The focus of this investigation was 240 women who were taking HRT at baseline; 134 of these women were randomized to the lifestyle intervention and the remaining 106 were randomized to the health education group. Participants were followed for 18 months. At 18 months, 110 (46%) of the women had continued HRT and the remaining 130 had discontinued HRT.

The lifestyle change group significantly decreased weight, Body Mass Index, waist circumference, total cholesterol and LDL-C, had improved fat intake and increased leisure physical activity, when compared to the health education group. In general, HRT discontinuation resulted in an increase in total cholesterol and LDL-C.

In the health education group, HRT discontinuers averaged over 22 mg/dL increase in total cholesterol and LDL-C while HRT continuers averaged less than 4 mg/dL increases. No such differences were observed in the lifestyle change group.

The lead author, Kelley K Pettee, Ph.D. currently a post-doctoral research associate at Arizona State University, states, "Considering the controversies regarding HRT, the findings from the present report are timely. These results have important public health implications and suggest that a non-pharmacological lifestyle approach is both safe and effective for CVD risk factor reduction in postmenopausal women, especially those who discontinued HRT use."

She continues, "CVD continues to be the leading cause of morbidity and mortality among women in westernized countries…Concern about the possible risks associated with HRT has left women and their heath care providers searching for safe and effective means to reduce CVD risk factors. One potential consequence of diminished HRT use is increased use of pharmacological agents, such as statins and aspirin; however, both are associated with side effects. Based on the findings of the current investigation, special attention should be paid to encouraging lifestyle strategies that are likely to impart more benefit and less risk than drug therapies."

The article is "Discontinuing Hormone Replacement Therapy: Attenuating the Effect on CVD Risk with Lifestyle Changes" by Kelley K. Pettee, PhD, Andrea M. Kriska, PhD, Molly B. Conroy, MD, B. Delia Johnson, PhD, Trevor J. Orchard, MD, Bret H. Goodpaster, PhD, Frani M. Averbach, RD, and Lewis H. Kuller, MD. It appears in the American Journal of Preventive Medicine, Volume 32, Issue 6 (June 2007) published by Elsevier.

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Full text of the article is available upon request; contact eAJPM@ucsd.edu to obtain copies. To request an interview with the lead author, please contact Frank Raczkiewic, News Bureau, University of Pittsburgh Schools of the Health Sciences at raczkiewiczfa@upmc.edu or 412 647 3555.

About the American Journal of Preventive Medicine
The American Journal of Preventive Medicine is the official journal of The American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials.

The American Journal of Preventive Medicine is ranked 14th out of 99 Public, Environmental & Occupational Health titles and 16th out of 105 General and Internal Medicine titles according to the Thomson Scientific Institute for Scientific Information's 2005 Journal Citation Reports.


About Elsevier
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