Author Affiliations: Laboratory of Personality and Cognition, National Institute on Aging, Baltimore, Md (Dr Resnick), and Departments of Geriatrics, Neurology, Pharmacology & Toxicology, and Epidemiology, University of Arkansas for Medical Sciences, Little Rock (Dr Henderson).
Interest in the effects of hormone therapy on health outcomes among
postmenopausal women has perhaps never been greater. As recently reported,1 the Women's Health Initiative (WHI) randomized clinical
trial of postmenopausal hormone therapy terminated the combined estrogen-progestin
arm (but not the estrogen-only arm) early after an average follow-up of 5.2
years (planned duration, 8.5 years).2 Women
who received estrogen plus progestin experienced a small but significant increase
in the primary outcome, coronary heart disease; a nonsignificant trend toward
an increase in the primary adverse outcome, invasive breast cancer; and a
significant increase in a global index (which included the 2 primary outcomes
plus stroke, pulmonary embolism, endometrial cancer, colorectal cancer, hip
fracture, and death due to other causes) summarizing risk and benefit. However,
the decision to stop this portion of the trial did not take into account several
other important outcomes that may affect a woman's choice of whether to take
hormone therapy, including potential effects on cognition. Two ancillary studies
to the WHI randomized trial focus on risk of dementia and cognitive decline,
but these outcomes are not considered in the WHI risk-benefit profile.
Resnick SM, Henderson VW. Hormone Therapy and Risk of Alzheimer Disease: A Critical Time. JAMA. 2002;288(17):2170–2172. doi:10.1001/jama.288.17.2170
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