Hormones & the Heart

Although both sexes normally secrete some female hormones (estrogens) from birth until death, by far the heaviest output is among women who are old enough to bear children. From early teens to the early 50s, women have a negligible incidence of heart attacks as compared with men. After the menopause, a woman's immunity gradually fades until, about the age of 75, she is statistically as susceptible to heart attacks as a man. If it is indeed the estrogens that confer middle-life immunity, can it be prolonged by taking estrogen tablets--and can men get this benefit without taking doses big enough to feminize them?

The answer to both questions is yes, according to investigators at the University of Southern California School of Medicine. Red-haired and vivacious at 60, Dr. Jessie Marmorston reported last week on 174 women (many over 70) who had had one or more heart attacks--in nearly every case a coronary occlusion. She divided them into two equal groups, matched as precisely as possible for age and severity of symptoms. One-half got a small daily dose (ten-millionths of a gram) of estrogen, the rest got none. After three years, more than twice as many in the nonestrogen group had died--virtually all from fresh heart attacks or general worsening of the disease.

Dr. Oliver Kuzma, working with Dr. Marmorston and her group, reported parallel evidence from a group of 109 men who got a slightly larger but virtually nonfeminizing dose of estrogen. In addition to an encouraging trend in the male death rate, Dr. Kuzma reported that in most cases the levels of cholesterol and other fat fractions circulating in the blood of heart-attack victims returned closer to normal, with no untoward feminizing effects. And Dr. Kuzma found that increasing the dosage, to the point where feminization was unmistakable, conferred no added advantage.

Though chemists are eagerly seeking a synthetic that will have the advantages but not the feminizing disadvantages of the natural estrogen, Drs. Marmorston and Kuzma see no need to wait for this millennium. They feel much good can be done with the currently available estrogens (marketed under different names by a dozen U.S. drug companies). Even on prescription, the low-dosage tablets should not cost more than a nickel a day.

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