MedWire News: Postmenopausal women with a low ratio of 'bad' to 'good' blood cholesterol have a low risk of suffering a heart attack related to hormone replacement therapy, say US researchers.

"We found that a simple and widely used blood test may be useful to advise women if they are at an increased risk of a heart attack while undergoing hormone therapy," said Professor Paul Bray, from Jefferson Medical College in Philadelphia, Pennsylvania.

He explained: "Because studies on hormone therapy have shown that they may increase heart attacks and strokes, many women have been reluctant to use this treatment.

"However, because hormones remain the most effective remedy for managing postmenopausal symptoms, such as hot flashes and night sweats, many women wanted to take this therapy, but have struggled with the decision because they feared the potential side effects."

Professor Bray and his team examined levels of various forms of blood cholesterol and markers of inflammation in 271 women with coronary heart disease and 707 healthy women who participated in a major study of hormone replacement therapy.

They found that hormone replacement therapy did not raise the risk of heart attacks in women with a ratio of 'bad' to 'good' cholesterol lower than 2.5.

But women with a ratio of 2.5 or higher were 73% more likely to suffer a heart attack if they took hormone replacement therapy.

Bray stressed that the blood test is not capable of predicting women's risk of suffering a stroke, which is also increased by use of hormone replacement therapy.

He said: "The findings do not change the current recommendation that hormone therapy should not be used for prevention of coronary heart disease - for prevention, women should focus on preventing and treating known risk factors such as high blood cholesterol and high blood pressure, and on avoiding smoking.

"Hormones should be used for the shortest time and lowest dose needed to obtain symptom relief."