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March 3, 1999

Hormone Replacement Therapy for Secondary Prevention of Coronary Heart Disease

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(9):794-797. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-9-jbk0303

To the Editor: The results of the Heart and Estrogen/progestin Replacement Study (HERS)1 provide important information about the effects of postmenopausal hormones, not only on the primary outcome, CHD, but also on other outcomes, such as fractures and breast cancer. Indeed, results are presented for virtually all the "secondary outcomes" listed in the trial protocol,2 but an important omission is that of endometrial hyperplasia. The trial protocol states that at least 3 endometrial biopsies (or ultrasounds) would be performed for each participant during the course of the trial. The HERS Research Group should provide data on the numbers of women diagnosed as having endometrial hyperplasia (with or without atypia) in the HRT and placebo arms, together with estimates of the associated relative hazard.