Postmenopausal Hormone Replacement Therapy: How Could We Have Been So Wrong?
Authors: Christine Laine
Journal: Annals of Internal Medicine (2002)

Editorials20 August 2002Postmenopausal Hormone Replacement Therapy: How Could We Have Been So Wrong?Christine Laine, MD, MPH, Senior Deputy EditorChristine Laine, MD, MPH, Senior Deputy EditorSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-4-200208200-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail While the public is hungry for medical discoveries that will immediately change clinical practice, evidence typically accumulates piecemeal and practice changes slowly. The early stoppage and release of the main results of the estrogen plus progestin component of the Women's Health Initiative (WHI) broke the typical pattern. This very large, methodologically rigorous randomized, controlled trial found that for every 10 000 women taking the hormone combination for 1 year (10 000 person-years), 7 more would have coronary events, 8 more would have strokes, 8 more would have pulmonary emboli, and 8 more would have invasive breast cancer than would 10 ...References1. 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. CrossrefMedlineGoogle Scholar2. Keating NL, Cleary PD, Rossi AS, Zaslavsky AM, Ayanian JZ. Use of hormone replacement therapy by postmenopausal women in the United States. Ann Intern Med. 1999;130:545-53. [PMID: 10189323] LinkGoogle Scholar3. Kreling D, Mott D, Wiederholt J, Lundy J, Levitt L. Prescription Drug Trends: A Chartbook Update. Menlo Park, CA: Kaiser Family Foundation; 2001. Google Scholar4. Stampfer MJ, Colditz GA. Estrogen replacement therapy and coronary heart disease: a quantitative assessment of the epidemiologic evidence. Prev Med. 1991;20:47-63. [PMID: 1826173] CrossrefMedlineGoogle Scholar5. Mendelsohn ME, Karas RH. The protective effects of estrogen on the cardiovascular system. N Engl J Med. 1999;340:1801-11. [PMID: 10362825] CrossrefMedlineGoogle Scholar6. Humphrey LL, Chan BKS, Sox HC. Postmenopausal hormone replacement therapy and the primary prevention of cardiovascular disease. Ann Intern Med. 2002;137:273-84. LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Christine Laine, MD, MPH, Senior Deputy EditorAffiliations: Corresponding Author: Customer Service, American College of Physicians–American Society of Internal Medicine, 190 N. Independence Mall West, Philadelphia, PA 19106.Current Author Address: Dr. Laine: American College of Physicians–American Society of Internal Medicine, 190 N. Independence Mall West, Philadelphia, PA 19106 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPostmenopausal Hormone Replacement Therapy and the Primary Prevention of Cardiovascular Disease Linda L. Humphrey , Benjamin K.S. Chan , and Harold C. 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