HRT Increases Stroke Risk

(HealthDay News) -- No matter when postmenopausal women start hormone replacement therapy (HRT), high doses of the treatment increase their risk of stroke, a new study finds.

The risk for stroke does appear lower in younger women taking HRT and in those taking the lowest doses of estrogen, Harvard researchers say. However, in women who took high doses of hormones, that increased risk was as much as 62 percent.

"If you take medium to higher doses of hormone therapy, you are at increased risk of stroke," said Dr. James Liu, chairman of the Department of Obstetrics and Gynecology at MacDonald Women's Hospital, University Hospitals Case Medical Center in Cleveland.

"If you are on estrogen, the risks of clotting abnormalities are slightly increased versus if you are not on estrogen," Liu said. "So, the risk of stroke is increased."

The report was published in the April 28 edition of the Archives of Internal Medicine.

In the study, Francine Grodstein and colleagues at Brigham and Women's Hospital and Harvard Medical School collected data on 121,700 women who participated in the Nurses' Health Study from 1976 to 2004.

The researchers looked at the association between HRT and stroke. Over the course of the study, 360 women who had never used HRT had strokes compared with 414 women taking hormones, Grodstein's team found.

"This increased risk was observed for women initiating hormone therapy at young ages or near menopause and at older ages or more than 10 years after menopause," the researchers wrote.

However, women taking HRT for less than five years at younger ages did not have a clear increase of stroke, which might be due to the small number of cases studied, the researchers noted.

"The incidence of stroke was relatively low in younger women, and the attributable risk in women aged 50 through 54 years indicated approximately an additional two cases of stroke per 10,000 women per year taking hormones," the researchers added.

Liu noted that older women are at an increased risk of stroke due to their age, whether or not they are taking HRT.

In addition, higher doses of estrogen were associated with an increased risk for stroke, Grodstein's group found. In fact, women taking high doses of estrogen increased their risk of stroke by 62 percent.

"In summary, our findings in the Nurses' Health Study indicate that hormone therapy is associated with an increased risk of stroke, regardless of the hormone regime or the timing of hormone therapy initiation," the researchers concluded. "However, in younger women, who are at lower absolute risk of stroke, the attributable risk of stroke owing to hormone use is modest, and our data suggest that risk might be further minimized by lower doses and shorter duration of treatment."

Liu noted that HRT is given differently than it was in 1976. "The doses we're using now are much, much lower," he said.

"The advice to women is, if you are on HRT, you should be on the lowest dose that will control your symptoms," Liu said. "In addition, you should be monitored and evaluated, and if you are going to continue on it; you need to understand what the risks are."

Another expert thinks only women with the most severe symptoms should start HRT, and then only at the lowest dose.

"You don't really see an increased risk of stroke with the lowest estrogen does," said Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City. "This study confirms that you should be on hormone replacement therapy for the shortest time possible at the lowest dose."

Wu thinks only women with the most severe menopausal symptoms who can't function well on a daily basis should start HRT. "We try to start [on] the lowest dose possible and decrease that dose even further, if possible," she said. "We keep them on a low dose for six months, and then take them off and see how they do."

Wyeth Pharmaceuticals, which sells the hormone therapy called Premarin, said in a statement that the findings reflect previous research and the current labeling on all hormone therapy products.

"Hormone therapy continues to be an effective option for many women when used at the lowest dose for the appropriate duration consistent with treatment goals and risk for the individual woman," Danielle Halstrom, senior director of global public relations at Wyeth Women's Health Care, said in a statement. "Hormone therapy is the most effective FDA-approved treatment for menopausal symptoms, and the benefits of hormone therapy may outweigh the risks for many symptomatic menopausal women."

More information
For more on hormone replacement therapy, visit the Women's Health Initiative.

Exercise Combats Cancer Fatigue

(HealthDay News) -- Exercise may help improve fatigue caused by cancer and its treatments, new research says.

"A lot of time, the medical response to patients is that they should expect to be fatigued, that it is a normal side effect. If patients are told that fatigue is just a side effect and to accept it, what they are not getting is any advice or support to help them cope," review lead author Fiona Camp, a lecturer at the University of the West of England in Bristol, said in a prepared statement.

Camp and her colleagues examined data on more than 2,000 cancer patients in 28 studies, which tested exercise programs that lasted from three weeks to eight months. The typical duration was 12 weeks. Walking and stationary bike riding were the most common types of exercise in the studies.

The researchers found that exercise is more effective at combating cancer-related fatigue than the usual care provided to patients.

"Exercise shouldn't be used in isolation but should definitely be included as one of the components in the package of interventions used during and after treatment," Camp said.

She said a clearer "exercise prescription" for cancer patients can be developed after experts learn more about what intensity, frequency, duration and kinds of exercise best suit cancer patients. Until then, available evidence shows that exercise therapists, physical therapists and exercise physiologists need to part of cancer patients' treatment teams, she added.

The review was published in the current issue of The Cochrane Library.

The first step in treating cancer-related fatigue is to check for any underlying medical conditions (such as anemia or an underactive thyroid) that can cause fatigue-like symptoms, said exercise researcher Karen Mustian, an assistant professor in the department of radiation oncology at the University of Rochester School of Medicine. She was not involved in the review.

"There will still be a fair amount of patients dealing with fatigue after we get other situations under control," Mustian said in a prepared statement.

"I think it's safe to say at this point that the sort of generalized guidelines of walking 30 minutes a day three to five times a week generally help patients. We can't say what specific doses are best. With the evidence currently out there, we can't say much beyond that," she said.

More information
The U.S. National Cancer Institute has more about cancer-related fatigue.

Ayurveda can prevent AIDS

Ayurveda can help in preventing AIDS by strengthening the body’s defence system through herbs and a supplementary code of conduct, doctors at a recent meeting of international policymakers on HIV here, said. “Apart from ‘Achaar Rasayan’ (code of conduct), the ancient system of Indian medicine provides for a whole range of herbs for the prevention of […]

Obesity prevention

When it comes to obesity prevention and management, Ayurveda has much to offer, with daily and seasonal regimens that include healthy foods, yoga exercise, panchakarma and medicines.

For obese patients, according to the symptoms of ama, digestive (dhatwagni deepan) and carminative (pachan) medications are given. Ayurvedic formulations of a guggulu kalpa decoction are also advised with […]

Dengue Cure discovered in Ayurveda

A recent research done by scholars of Burdwan University in the suburbs of Kolkata has shown that the berries of a wild weed used in Ayurvedic formulation can help to eradicate mosquitoes spreading dengue and act as a resistant to synthetic insecticide.

The weed which helps in eradicating dengue is known as Solanum villosum which a member of the family of nightshade possessing medical properties and are used as Ayurvedic herbs.

About two fifth of the total population of the world is now at risk from dengue which is characterized by high fever, pain and rashes. Dengue haemorrhagic fever is the most complicated type which most likely affects children. In the recent years there have been quite a few deaths in Kolkata because of this disease. With this path breaking discovery a cure for Dengue is likely to be found soon.

This research has been carried out in the University of Burdwan where the juice from the berries have been extracted and used on the mosquitoes spreading yellow fever and dengue. The researchers have found out that the extracts of this weed is highly effective in killing the larvae of S.aegypti responsible for spreading dengue. The researchers claimed that the extracts of this weed is not as strong as Malathion but it has the capability to kill the mosquitoes of stagnant water.

Himachal Pradesh to provide Ayurveda for public health

Shimla: Here’s good news for patients visiting Himachal Pradesh rural health centers. They may soon be able to consult both allopathic and ayurvedic doctors for treatment.

Top government officials said Friday that a proposal has been sent to the central health ministry. If approved, it could offer a better option to patients who would benefit from both streams of medicine.

In the first phase, 250 public health centers and 70 community health centers, which already have allopathic doctors posted along with other paramedic staff, will also have an ayurvedic doctor to assist patients.