Postmenopausal hormone therapy before and after the women's health initiative study: what consequences?
This review focuses on the question of whether the Women's Health Initiative (WHI) was a test of primary versus secondary cardiovascular benefits of postmenopausal hormone therapy. Evidence is presented to support the conclusion that the WHI was a secondary intervention trial and that primary cardiovascular benefits of hormone therapy are rational, likely, but not yet proven. The review makes clear that hormone therapy is not a 'cardiovascular drug' for the treatment of coronary heart disease; but rather that the public health debate is whether hormone therapy, used for the treatment of menopausal symptoms, provides any cardiovascular benefits that might offset its risk.
Mikkola
Tomi S
TS
Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland.
Clarkson
Thomas B
TB
Notelovitz
Morris
M
D000367:Age Factors; D001943:Breast Neoplasms / Q000209:etiology; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control*; D004334:Drug Administration Schedule; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control; D017698:Postmenopause; D011322:Primary Prevention; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012306:Risk