Massey CV, Hupp CH, Kreisberg M, Alpert MA, Hoff C.
Estrogen replacement therapy is underutilized among postmenopausal women at high risk for coronary heart disease.
Am J Med Sci 2000;320(2):124-7.

The purpose of this study was to measure estrogen utilization in an economically and racially diverse group of women at high risk for the development of coronary heart disease (CHD). Data for this study were drawn from charts of all women over 40 years of age admitted to the University of South Alabama Medical Center from 1990 through 1994 with suggestive angina.

In the sample of 263 postmenopausal women at high risk for CHD, 68% had undergone hysterectomy, 59% before the age of 40. There were no statistically significant race differences in the use of this procedure. Only 37 (14.1%) were receiving estrogen replacement therapy (ERT) at the time of admission. The utilization of ERT was lower in African American women (11 of 111, 9.9%) than in European American women (26 of 152, 17.1%), although the difference was not statistically significant (p<0.10).

The authors suggest that low socioeconomic status and education level and a high number of coronary risk factors are possible reasons for the lower rate of use of ERT in this cohort. Despite the lack of clinical data to assess the appropriateness of treatment offered, the authors conclude that ERT is underutilized in this economically and racially diverse group of women, with African American women half as likely as European Americans to receive ERT.