Health outcomes follow up of the Women’s Health Intiative study

January 01, 0001

Health outcomes follow up of the Women’s Health Intiative study

The Women's Health Initiative created quite a stir when it was stopped prematurely due to an increased risk of stroke in patients receiving estrogen replacement. These US researchers performed postintervention follow up for women treatment with conjugated equine estrogens (CEE) and whom were s/p hyster(n=7645).

The researchers found: "The postintervention risk (annualized rate) for CHD among women assigned to CEE was 0.64% compared with 0.67% in the placebo group (hazard ratio {HR}, 0.97;), 0.26% vs 0.34%, respectively, for breast cancer (HR, 0.75), and 1.47% vs 1.48%, respectively, for total mortality (HR, 1.00). The risk of stroke was no longer elevated during the postintervention follow-up period and was 0.36% among women receiving CEE compared with 0.41% in the placebo group (HR, 0.89), the risk of deep vein thrombosis was lower at 0.17% vs 0.27%, respectively (HR, 0.63), and the risk of hip fracture did not differ significantly and was 0.36% vs 0.28%, respectively (HR, 1.27). Over the entire follow-up, lower breast cancer incidence in the CEE group persisted and was 0.27% compared with 0.35% in the placebo group (HR, 0.77). Health outcomes were more favorable for younger compared with older women for CHD, total myocardial infarction, colorectal cancer, total mortality, and global index of chronic diseases."

The researchers concluded: "Among postmenopausal women with prior hysterectomy followed up for 10.7 years, CEE use for a median of 5.9 years was not associated with an increased or decreased risk of CHD, deep vein thrombosis, stroke, hip fracture, colorectal cancer, or total mortality. A decreased risk of breast cancer persisted."

There were no post-intervention health risks identified in the ten years following the Women’s Health Intiative Trial among women s/p hysterectomy who received conjugated equine estrogens.

For the full abstract, click here.

JAMA 305(13):1305-1314, 6 April 2011 © 2011 American Medical Association
Health Outcomes After Stopping Conjugated Equine Estrogens Among Postmenopausal Women With Prior Hysterectomy. Andrea Z. LaCroix, Rowan T. Chlebowski, JoAnn E. Manson, et al.

Category: A. General/Unspecified. Keywords: conjugated equine estrogens, estrogen replacement, stroke, breast cancer, Women’s Health Intitiative Estrogen-Alone Trial, post-intervention follow-up of randomized controlled trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 26 April 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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