Issue: March 2008
March 10, 2008
1 min read
Save

HT had no significant impact on MI risk in WHI replication trial

Issue: March 2008

Compared with older women, coronary heart disease is not prevented by hormone therapy in younger postmenopausal women.

Using methodology from their U.K. General Practice Research Database (GPRD) study of older women, researchers at the University of Pennsylvania analyzed data from a younger cohort — women aged 50 to 55 — to replicate the Women’s Health Initiative randomized controlled trial.

The researchers compared data from 30,102 unexposed and 20,654 exposed women treated with conjugated estrogens and norgestrel.

In younger women, hormone therapy did not significantly alter myocardial infarction (HR=0.91; 95% CI, 0.69-1.20). Breast cancer, hip fracture, stroke and venous thromboembolic events were comparable with the GPRD analysis of older women and the WHI randomized control trial.

Death was decreased in the total group, similar to older women, but not considerably changed in a subset without missing covariate data, the researchers wrote. – by Stacey L. Adams

Menopause. 2008;15:86-93.

PERSPECTIVE

This is an interesting but unconventional U.K. study using a nonrandomized treatment cohort to track outcomes and compare them with findings reported from large randomized clinical trials. The outcomes of cardiovascular disease, stroke, venothrombotic disease and cancer were similar to the results from the WHI estrogen plus progesterone randomized clinical trial reported in 2002, even among the 50- to 55-year-old women. However, these findings are only suggestive, as with any cohort or observational study, and ideally should be tested in a true randomized clinical trial.

–Marian Limacher, MD

Professor of Medicine, Division of Cardiovascular Medicine, University of Florida in Gainesville