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Commentary
March 8, 2004

Evaluation of Cardiovascular Event Rates With Hormone Therapy in Healthy, Early Postmenopausal WomenResults From 2 Large Clinical Trials

Arch Intern Med. 2004;164(5):482-484. doi:10.1001/archinte.164.5.482

Despite observational data suggesting that hormone therapy (HT) decreases the risk of coronary heart disease (CHD) in healthy postmenopausal women,1 2 large, randomized controlled trials that evaluated older postmenopausal women with2 or without3 established CHD observed an increased risk of early events in women taking HT. In both of these trials 0.625 mg of oral conjugated equine estrogens (CEE) was used, combined continuously with 2.5 mg of medroxyprogesterone acetate (MPA), and both trials found an increased risk of events within the first year.3 However, in the Women's Health Initiative (WHI) trial, women with severe menopausal symptoms were excluded from participation and only one third of the participants receiving active treatment were younger than 60 years (average age, 63 years). Because most women use HT for symptom relief in their early menopausal years, understanding early CHD risk in the younger postmenopausal population is important. Therefore, the incidence of CHD events was evaluated in 4065 young, healthy postmenopausal women who participated in 2 large randomized clinical trials of HT conducted between 1989 and 2001 in Europe, and data for the United States were obtained from Wyeth Research, Philadelphia, Pa. Wyeth is the manufacturer of CEE and was the sponsor of these 2 prospective randomized trials.

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