The Women's Health Initiative could not have detected cardioprotective effects of starting hormone therapy during the menopausal transition.
The Women's Health Initiative (WHI) randomized controlled trial failed to show cardioprotection by estrogen plus progestin treatment of postmenopausal women. But by design, the WHI population was 10-fold underpowered to show cardioprotection of women starting hormone treatment during the menopausal transition. Thus, observational studies that showed cardioprotection in such women remain the only applicable clinical guide to this issue. Randomized controlled trials are urgently needed to test cardioprotection in women starting treatment during the menopausal transition.
Naftolin
Frederick
F
Yale University, Department of Obstetrics, Gynecology and Reproductive Sciences, New Haven, Connecticut 06520-8063, USA. frederick.naftolin@yale.edu
Taylor
Hugh S
HS
Karas
Richard
R
Brinton
Eliot
E
Newman
Isadore
I
Clarkson
Thomas B
TB
Mendelsohn
Michael
M
Lobo
Rogerio A
RA
Judelson
Debra R
DR
Nachtigall
Lila E
LE
Heward
Christopher B
CB
Hecht
Harvey
H
Jaff
Michael R
MR
Harman
S Mitchell
SM
D002318:Cardiovascular Diseases / Q000517:prevention & control*; D015914:Estrogen Replacement Therapy / Q000592:standards*; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D016387:Women's Health