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HRT drugs may help blood pressure

Women weighing the pros and cons of hormone replacement therapy (HRT) now have one additional factor to consider -- a new generation of HRT treatments containing drospirenone are touted as beneficial for lowering the blood pressure of hypertensive post-menopausal women.

Santiago Palacios, the director of the Palacios Institute of Women's Health, said drospirenone is a Progestogen with Aldosterone Receptor Antagonism (PARA).

"The PARA effect is what differentiates drospirenone from other progestines," Palacios said.

Progestines are chemicals that mimic the action of the hormone progesterone. Drospirenone's property as an aldosterone-receptor agonist also means that it does not cause patients to retain water like previous HRT treatments, Palacios said, speaking at a Taipei press conference yesterday, sponsored by Bayer.

Bayer is the manufacturer of a drospirenone-containing HRT treatment that will be launched in Taiwan later this month.

Not available

According to John Wheatley, a strategic business unit manager with Schering Taiwan, the low price ceiling for HRT drugs offered by Taiwan's National Health Insurance (NHI) means that the new drospirenone-containing HRT drug will not be available on Taiwan's NHI.

"We didn't even consider it, the price for that whole group is too low," Wheatley said. "If we did not introduce it on a a self-pay basis we would not be introducing it to this market at all."

HRT use declined worldwide, including in Taiwan, when a Women's Health Initiative study found that HRT did not lower the risk for coronary heart disease but did cause a 26 percent increase in breast cancer and a 41 percent increase in strokes.

"The WHI study definitely had a big impact in Taiwan," said Horng Shiow-shiun (洪秀勳), the third-division manager (科長) of the Bureau of Health Promotion. "We noticed fewer and fewer women opting for HRT, and doctors were also more discriminating about when they would prescribe it."

Horng said the latest study of over 6,000 older Taiwanese women conducted by the bureau in 2005 showed that only 14.4 percent of women suffering from menopausal and post-menopausal symptoms are taking HRT, a decrease from the previous study.

Perspective

"There is a downside for every drug," said Hsu Ming-I (許明義), the director of the division of reproductive medicine at Wangfang Hospital. "But the important thing is to look at the dangers in perspective."

"To replace HRT, a woman might have to take multiple drugs -- painkillers, anti-depressants, sleep medications -- each with their own side effects," Hsu said.
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