Journal article
Randomized Trial Evaluation of the Benefits and Risks of Menopausal Hormone Therapy Among Women 50-59 Years of Age
American journal of epidemiology, Vol.190(3), pp.365-375
03/01/2021
DOI: 10.1093/aje/kwaa210
PMCID: PMC8086238
PMID: 33025002
Abstract
The health benefits and risks of menopausal hormone therapy among women aged 50-59 years are examined in the Women's Health Initiative randomized, placebo-controlled trials using long-term follow-up data and a parsimonious statistical model that leverages data from older participants to increase precision. These trials enrolled 27,347 healthy postmenopausal women aged 50-79 years at 40 US clinical centers during 1993-1998, including 10,739 post-hysterectomy participants in a trial of conjugated equine estrogens and 16,608 participants with a uterus in the trial of these estrogens plus medroxyprogesterone acetate. Over a (median) 18-year follow-up period (1993-2016), risk for a global index (defined as the earliest of coronary heart disease, invasive breast cancer, stroke, pulmonary embolism, colorectal cancer, endometrial cancer, hip fracture, and all-cause mortality) was reduced with conjugated equine estrogens with a hazard ratio of 0.82 (95% confidence interval: 0.71, 0.95), and with nominally significant reductions for coronary heart disease, breast cancer, hip fracture, and all-cause mortality. Corresponding global index hazard ratio estimates of 1.06 (95% confidence interval: 0.95, 1.19) were nonsignificant for combined estrogens plus progestin, but increased breast cancer risk and reduced endometrial cancer risk were observed. These results, among women 50-59 years of age, substantially agree with the worldwide observational literature, with the exception of breast cancer for estrogens alone.
Details
- Title: Subtitle
- Randomized Trial Evaluation of the Benefits and Risks of Menopausal Hormone Therapy Among Women 50-59 Years of Age
- Creators
- Ross L. Prentice - Fred Hutchinson Canc Res Ctr, Publ Hlth Sci Div, 1100 Fairview Ave N,M3-A410, Seattle, WA 98109 USAAaron K. Aragaki - Fred Hutch Cancer CenterRowan T. Chlebowski - Biomed Research InstituteJacques E. Rossouw - NHLBI, Bldg 10, Bethesda, MD 20892 USAGarnet L. Anderson - Fred Hutch Cancer CenterMarcia L. Stefanick - Stanford UniversityJean Wactawski-Wende - University at Buffalo, State University of New YorkLewis H. Kuller - University of PittsburghRobert Wallace - University of IowaKaren C. Johnson - University of Tennessee at KnoxvilleAladdin H. Shadyab - University of California - San Diego School of MedicineMargery Gass - North Amer Menopause Soc Emeritus, Pepper Pike, OH USAJoAnn E. Manson - Brigham and Women's Hospital
- Resource Type
- Journal article
- Publication Details
- American journal of epidemiology, Vol.190(3), pp.365-375
- DOI
- 10.1093/aje/kwaa210
- PMID
- 33025002
- PMCID
- PMC8086238
- NLM abbreviation
- Am J Epidemiol
- ISSN
- 0002-9262
- eISSN
- 1476-6256
- Publisher
- Oxford Univ Press
- Number of pages
- 11
- Grant note
- R01 CA119171; R01 CA210921 / National Cancer Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) HHSN268201100046C; HSN268201600001C; HHSN268201600002C; HHSN268201600003C; HHSN268201600004C; HHSN271201600004C / National Heart, Lung, and Blood Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
- Language
- English
- Date published
- 03/01/2021
- Academic Unit
- Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984363576902771
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