Menopausal Hormone Therapy and Risk for Cardiovascular Disease in the WHI Trial
Authors: Jerome L. Sullivan
Journal: Annals of Internal Medicine (2010)

Letters6 July 2010Menopausal Hormone Therapy and Risk for Cardiovascular Disease in the WHI TrialJerome L. Sullivan, MD, PhDJerome L. Sullivan, MD, PhDFrom University of Central Florida College of Medicine, Orlando, FL 32816.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-1-201007060-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The WHI was based on an expectation of no less than a 30% reduction in CVD mortality in women receiving hormone replacement therapy (HRT) (1). With the “timing hypothesis” effectively eliminated by Toh and colleagues (2), the meaning of the results of the trial should be revisited. Failure to show any reduction in mortality, let alone a 30% reduction, has far-reaching implications beyond the recommendation that HRT not be used for prevention of CVD. The large expected decrease in disease was related to the much lower CVD rates of menstruating women. The fact that the WHI found ...References1. Eaker E, Hahn RA. Women's health initiative [Letter]. N Engl J Med. 1994;330:70-1. [PMID: 8259163] CrossrefMedlineGoogle Scholar2. 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 Scholar3. Sullivan JL. Iron and the sex difference in heart disease risk. Lancet. 1981;1:1293-4. [PMID: 6112609] CrossrefMedlineGoogle Scholar4. Sullivan JL. Are menstruating women protected from heart disease because of, or in spite of, estrogen? Relevance to the iron hypothesis [Editorial]. Am Heart J. 2003;145:190-4. [PMID: 12595829] CrossrefMedlineGoogle Scholar5. Sullivan JL. Is homocysteine an iron-dependent cardiovascular risk factor? Kidney Int. 2006;69:642-4. [PMID: 16467888] CrossrefMedlineGoogle Scholar6. Sullivan JL. Do hemochromatosis mutations protect against iron-mediated atherogenesis? Circ Cardiovasc Genet. 2009;2:652-7. [PMID: 20031646] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Jerome L. Sullivan, MD, PhDAffiliations: From University of Central Florida College of Medicine, Orlando, FL 32816.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCoronary 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 Sengwee Toh , Jacques E. Rossouw , and Miguel A. Hernán Menopausal Hormone Therapy and Risk for Cardiovascular Disease in the WHI Trial S. Mitchell Harman , Eliot A. Brinton , Frederick Naftolin , George R. Merriam , Marcelle I. Cedars , Ruth G. Freeman , and Nanette Santoro Menopausal Hormone Therapy and Risk for Cardiovascular Disease in the WHI Trial Amos Pines and David Sturdee Metrics 6 July 2010Volume 153, Issue 1Page: 61KeywordsCardiovascular diseasesCardiovascular therapyConflicts of interestHormonal therapyHormone replacement therapyHormonesMenopauseMortalityMotivation ePublished: 6 July 2010 Issue Published: 6 July 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...