Menopausal Hormone Therapy and Risk for Cardiovascular Disease in the WHI Trial
Authors: S. Mitchell Harman, Eliot A. Brinton, Frederick Naftolin, George R. Merriam, Marcelle I. Cedars, Ruth G. Freeman, Nanette Santoro
Journal: Annals of Internal Medicine (2010)

Letters6 July 2010Menopausal Hormone Therapy and Risk for Cardiovascular Disease in the WHI TrialS. Mitchell Harman, MD, PhD, Eliot A. Brinton, MD, Frederick Naftolin, MD, PhD, George R. Merriam, MD, Marcelle I. Cedars, MD, Ruth G. Freeman, MD, and Nanette Santoro, MDS. Mitchell Harman, MD, PhDFrom Kronos Longevity Research Institute, Phoenix, AZ 85016; University of Utah School of Medicine, Salt Lake City, UT 84108; New York University School of Medicine, New York, NY 10016; University of Washington School of Medicine, Seattle, WA 98195; University of California at San Francisco, San Francisco, CA 94115; Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461; and University of Colorado at Denver, Aurora, CO 80045.Search for more papers by this author, Eliot A. Brinton, MDFrom Kronos Longevity Research Institute, Phoenix, AZ 85016; University of Utah School of Medicine, Salt Lake City, UT 84108; New York University School of Medicine, New York, NY 10016; University of Washington School of Medicine, Seattle, WA 98195; University of California at San Francisco, San Francisco, CA 94115; Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461; and University of Colorado at Denver, Aurora, CO 80045.Search for more papers by this author, Frederick Naftolin, MD, PhDFrom Kronos Longevity Research Institute, Phoenix, AZ 85016; University of Utah School of Medicine, Salt Lake City, UT 84108; New York University School of Medicine, New York, NY 10016; University of Washington School of Medicine, Seattle, WA 98195; University of California at San Francisco, San Francisco, CA 94115; Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461; and University of Colorado at Denver, Aurora, CO 80045.Search for more papers by this author, George R. Merriam, MDFrom Kronos Longevity Research Institute, Phoenix, AZ 85016; University of Utah School of Medicine, Salt Lake City, UT 84108; New York University School of Medicine, New York, NY 10016; University of Washington School of Medicine, Seattle, WA 98195; University of California at San Francisco, San Francisco, CA 94115; Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461; and University of Colorado at Denver, Aurora, CO 80045.Search for more papers by this author, Marcelle I. Cedars, MDFrom Kronos Longevity Research Institute, Phoenix, AZ 85016; University of Utah School of Medicine, Salt Lake City, UT 84108; New York University School of Medicine, New York, NY 10016; University of Washington School of Medicine, Seattle, WA 98195; University of California at San Francisco, San Francisco, CA 94115; Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461; and University of Colorado at Denver, Aurora, CO 80045.Search for more papers by this author, Ruth G. Freeman, MDFrom Kronos Longevity Research Institute, Phoenix, AZ 85016; University of Utah School of Medicine, Salt Lake City, UT 84108; New York University School of Medicine, New York, NY 10016; University of Washington School of Medicine, Seattle, WA 98195; University of California at San Francisco, San Francisco, CA 94115; Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461; and University of Colorado at Denver, Aurora, CO 80045.Search for more papers by this author, and Nanette Santoro, MDFrom Kronos Longevity Research Institute, Phoenix, AZ 85016; University of Utah School of Medicine, Salt Lake City, UT 84108; New York University School of Medicine, New York, NY 10016; University of Washington School of Medicine, Seattle, WA 98195; University of California at San Francisco, San Francisco, CA 94115; Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461; and University of Colorado at Denver, Aurora, CO 80045.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-1-201007060-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We applaud Toh and colleagues (1) for delving deeper into the still-controversial issue of inconsistencies in the outcomes of cardiovascular disease (CVD) between the Women's Health Initiative (WHI) estrogen plus progestin hormone trial and previous large observational studies. Current evidence suggests that both the timing of initiation and the duration of menopausal hormone therapy (2, 3) are important determinants of the risk–benefit ratio. The data presented by Toh and colleagues suggest that the slightly higher CVD risk in the first 2 years of treatment leads to a lower risk after 6 or more years of use only ...References1. Toh S, Hernández-Díaz S, Logan R, Rossouw JE, Hernán MA. Coronary heart disease in postmenopausal recipients of estrogen plus progestin therapy: does the increased risk ever disappear? A randomized trial. Ann Intern Med. 2010;152:211-7. [PMID: 20157135] LinkGoogle Scholar2. Grodstein F, Manson JE, Stampfer MJ. Postmenopausal hormone use and secondary prevention of coronary events in the Nurses' Health Study. A prospective, observational study. Ann Intern Med. 2001;135:1-8. [PMID: 11434726] LinkGoogle Scholar3. Chilvers CE, Knibb RC, Armstrong SJ, Woods KL, Logan RF. Post menopausal hormone replacement therapy and risk of acute myocardial infarction—a case control study of women in the East Midlands, UK. Eur Heart J. 2003;24:2197-205. [PMID: 14659771] CrossrefMedlineGoogle Scholar4. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, et al; Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. JAMA. 2002;288:321-33. [PMID: 12117397] CrossrefMedlineGoogle Scholar5. Manson JE, Hsia J, Johnson KC, Rossouw JE, Assaf AR, Lasser NL, et al; Women's Health Initiative Investigators. Estrogen plus progestin and the risk of coronary heart disease. N Engl J Med. 2003;349:523-34. [PMID: 12904517] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Kronos Longevity Research Institute, Phoenix, AZ 85016; University of Utah School of Medicine, Salt Lake City, UT 84108; New York University School of Medicine, New York, NY 10016; University of Washington School of Medicine, Seattle, WA 98195; University of California at San Francisco, San Francisco, CA 94115; Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461; and University of Colorado at Denver, Aurora, CO 80045.Disclosures: All authors are co-principal investigators of KEEPS (Kronos Early Estrogen Prevention Study), an investigation of cardiovascular effects of oral versus transdermal hormone treatment in recently menopausal women. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPostmenopausal Hormone Use and Secondary Prevention of Coronary Events in the Nurses' Health Study: A Prospective, Observational Study Francine Grodstein , JoAnn E. Manson , and Meir J. Stampfer Coronary Heart Disease in Postmenopausal Recipients of Estrogen Plus Progestin Therapy: Does the Increased Risk Ever Disappear? Sengwee Toh , Sonia Hernández-Díaz , Roger Logan , Jacques E. Rossouw , and Miguel A. Hernán Menopausal Hormone Therapy and Risk for Cardiovascular Disease in the WHI Trial Amos Pines and David Sturdee Menopausal Hormone Therapy and Risk for Cardiovascular Disease in the WHI Trial Jerome L. Sullivan Menopausal Hormone Therapy and Risk for Cardiovascular Disease in the WHI Trial Sengwee Toh , Jacques E. Rossouw , and Miguel A. Hernán Metrics Cited BySex and Gender Differences in Cardiovascular Disease 6 July 2010Volume 153, Issue 1Page: 60-61KeywordsCardiovascular diseasesEstrogensForecastingHormonal therapyHormonesMenopauseObservational studiesObstetrics and gynecologyRisk management ePublished: 6 July 2010 Issue Published: 6 July 2010 CopyrightCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...