Conjugated equine estrogens and coronary heart disease: the Women's Health Initiative
Authors
Hsia, JudithLanger, Robert D
Manson, Joann E
Kuller, Lewis
Johnson, Karen C.
Hendrix, Susan L
Pettinger, Mary
Heckbert, Susan R
Greep, Nancy
Crawford, Sybil L.
Eaton, Charles B.
Kostis, John B.
Caralis, Pat
Prentice, Ross
UMass Chan Affiliations
Department of Medicine, Division of Preventive and Behavioral MedicineDocument Type
Journal ArticlePublication Date
2006-02-13Keywords
Age DistributionAged
Blood Glucose
C-Reactive Protein
Cholesterol
Estrogens
Estrogens, Conjugated (USP)
Female
Follow-Up Studies
*Hormone Replacement Therapy
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Insulin
Male
Middle Aged
Myocardial Infarction
Myocardial Revascularization
Postmenopause
Proportional Hazards Models
Triglycerides
United States
Life Sciences
Medicine and Health Sciences
Women's Studies
Metadata
Show full item recordAbstract
BACKGROUND: In recent randomized trials, conjugated equine estrogens (CEE) with continuous medroxyprogesterone acetate provided no protection against coronary heart disease in postmenopausal women and may have increased cardiac risk. These trials did not address the role of unopposed estrogen for coronary protection. METHODS: A total of 10 739 women aged 50 to 79 years at baseline (mean age, 63.6 years) who had previously undergone hysterectomy were randomized to receive CEE, 0.625 mg/d, or placebo at 40 US clinical centers beginning in 1993. The trial was terminated early after 6.8 years of follow-up (planned duration, 8.5 years). This report includes final, centrally adjudicated results for the primary efficacy outcome (myocardial infarction or coronary death), secondary coronary outcomes, and subgroup analyses. RESULTS: During the active intervention period, 201 coronary events were confirmed among women assigned to receive CEE compared with 217 events among women assigned to receive placebo (hazard ratio, 0.95; nominal 95% confidence interval, 0.79-1.16). Among women aged 50 to 59 years at baseline, the hazard ratio for the primary outcome was 0.63 (nominal 95% confidence interval, 0.36-1.08). In that age group, coronary revascularization was less frequent among women assigned to receive CEE (hazard ratio, 0.55; nominal 95% confidence interval, 0.35-0.86), as were several composite outcomes, which included the primary outcome and coronary revascularization (hazard ratio, 0.66; nominal 95% confidence interval, 0.44-0.97). CONCLUSIONS: Conjugated equine estrogens provided no overall protection against myocardial infarction or coronary death in generally healthy postmenopausal women during a 7-year period of use. There was a suggestion of lower coronary heart disease risk with CEE among women 50 to 59 years of age at baseline.Source
Arch Intern Med. 2006 Feb 13;166(3):357-65. Link to article on publisher's siteDOI
10.1001/archinte.166.3.357Permanent Link to this Item
http://hdl.handle.net/20.500.14038/50881PubMed ID
16476878Related Resources
Link to article in PubMedae974a485f413a2113503eed53cd6c53
10.1001/archinte.166.3.357