August 13, 1997

Facilitating Patient-Specific Decisions Regarding Hormone Replacement Therapy-Reply

Author Affiliations

Tufts University School of Medicine Boston, Mass

JAMA. 1997;278(6):476. doi:10.1001/jama.1997.03550060052028

In Reply.  —Dr Rozenberg and colleagues observed that Belgian gynecologists consider risk factors for osteoporosis, but not for CHD, when prescribing HRT. Similarly, recent surveys of US women found that CHD prevention was rarely cited as the reason for initiating HRT1 and that women with risk factors for CHD were no more likely to receive HRT than those without risk factors.2 In our study, we attempted neither to describe nor to explain current prescribing practices, but only to provide a means of quantifying the expected gains and loses from HRT for specific women and perhaps identify those women who could benefit most. Primarily, our model provides women and their physicians with information about the risks of osteoporosis, breast cancer, and cardiovascular disease for the individual and the effect of HRT on these risks.Dr Weiss questions whether the relative impact of HRT is constant among women with differing levels of