Hormone therapy for younger women may not increase CHD risk during 5 to 7 years of follow-up, but stroke risk was increased independent of age

摘要

The WHI trials clearly showed that no justification exists for initiationnof HT in older asymptomatic women as a preventive health strategy. Innthis population, risks for CHD, stroke, venous thromboembolism, andnbreast cancer outweigh benefits for hip fracture and colorectal cancer.nLess clear is the balance of risks and benefits in symptomatic perimenopausalnwomen and in rare cases when HT is being considered for oldernsymptomatic women. After pooling data from the 2 WHI trials, includingn8832 women aged 50 to 59 years, Rossouw and colleaguesnconcluded that, in this age group, HT did not increase risk for any outcomenand total mortality was reduced, translating into 1 fewer deathnper 1000 women per year. In women with no history of cardiovascularndisease, the hazard ratio for CHD by decade after menopause wentnfrom a low of 0.78 for < 10 years, to 1.10 for 10 to 19 years, to 1.35nfor ≥ 20 years (P for trend 0.02). Overall, HT users in the WHI hadnincreased risk for stroke (estimated at 9/10 000 women-years of use),nand this risk did not differ on the basis of years since menopause.nAmong women 50 to 59 years of age, no statistically significantnincrease in stroke was found.