No Long-Term Primary-Prevention Benefit with Combination HRT

Combination hormone replacement therapy should not be initiated or continued long-term for the primary prevention of coronary heart disease.

Results from the HERS II study (JW Cardiology Aug 23 2002) show that hormone replacement therapy (HRT) should not be used for secondary prevention of adverse heart events in postmenopausal women with coronary heart disease (CHD). But what about for primary prevention in healthy women? The Women's Health Initiative (WHI), a series of trials involving 161,809 postmenopausal women, includes a randomized, placebo-controlled trial of combination HRT use (estrogen plus progestin) in 16,608 women (age range, 50-79) without CHD and with a uterus.

After 5.2 of the planned 8.5 years of follow-up, the trial was halted because the data revealed an increased risk for invasive breast cancer, CHD events (nonfatal MI or CHD death), stroke, and pulmonary emb…

Reviewing Author

JoAnne M. Foody, MD