Risks and Benefits of Estrogen/Progestin in Healthy Women (WHI)-2002

Abstract

Between 1990 and 1992, various research pointed to potential cardio-protection in postmenopausal women users of hormone therapy (HT). Due to the favorable effects of HT on lipids, attention was focused on the possible use of postmenopausal HT as a strategy for primary prevention of cardiovascular disease. 1998’s Heart and Estrogen/progestin Replacement Study (HERS) trial reported an apparent increased risk of Coronary Heart Disease (CHD) in the first year of hormone use for those with documented prior CHD [1]. This prompted speculation that any early adverse effect of hormones on CHD incidence was confined to women with prior CHD events. The Women’s Health Initiative (WHI) clinical trial looked specifically at this issue of potential risks and benefits of HT for otherwise healthy postmenopausal women. The Women’s Health Initiative is a large long-term national health study sponsored by the National Heart, Lung and Blood Institute, focused on preventing heart disease and breast and colorectal cancers. The original study had 3 parts: a clinical trial of postmenopausal hormone use, vitamin D and calcium supplementation and low-fat dietary patterns, an observational trial, and a community prevention study. The postmenopausal hormone trial had two separate studies: the estrogen-plus-progestin study of women with a uterus and the estrogen-alone study of women without a uterus. This is a review of the most often cited WHI data, the estrogen-plus-progestin combined hormone clinical trial.

Rossouw JE, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results from the Women's Health Initiative randomized controlled trial. JAMA 2002; 288:321–333.

Hyperlink to PDF: https://jamanetwork.com/journals/jama/fullarticle/195120.