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November 28, 2001

Estrogen for Bone Health in Frail Elderly Women

Author Affiliations
 

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;286(20):2544. doi:10.1001/jama.286.20.2542

To the Editor: Dr Villareal and colleagues1 found that frail elderly women who received 9 months of hormone replacement therapy (HRT) had significantly increased bone mineral density. Although the authors excluded women with active serious illness, they did not indicate whether they excluded women with a history of coronary artery disease (CAD). The Heart and Estrogen/Progestin Replacement Study (HERS)2 reported that women with coronary artery disease are at increased risk for cardiovascular events in the first year of HRT. However, Villareal et al followed up their patients for only 9 months. Given the high prevalence of CAD in older women (33% in women older than 65 years),3 alternatives to estrogen for bone health, such as bisphosphonates, are appropriate for many patients.

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