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July 5, 2000

Early Risks of Hormone Therapy in Patients With Coronary Heart Disease

Author Affiliations

Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthor

JAMA. 2000;284(1):41-43. doi:10.1001/jama.284.1.39

To the Editor: An early increase in coronary death and nonfatal myocardial infarction (MI) in postmenopausal women with coronary heart disease (CHD) taking hormone therapy compared with placebo was an unanticipated adverse outcome in the Heart and Estrogen/progestin Replacement Study (HERS).1 The time trend for initial risk and later benefit was statistically significant. Two of us (N.K.W. and G.L.K.) involved in the HERS study recognized some striking similarities between the results of this clinical trial in postmenopausal women with those of the Coronary Drug Project (CDP)2 (with which all 3 of us were involved), conducted almost 3 decades earlier in men. HERS and CDP are the only large trials of hormone therapy in populations with CHD, and both data sets could be analyzed further owing to our personal involvement. This report compares the primary outcomes of these trials with particular focus on early excess events following initiation of hormone therapy.

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