The latest elaboration of the Women's Health Initiative data on hormone replacement therapy and cardiovascular disease in postmenopausal women.

摘要

The saga continues. The Women's Health Initiative (WHI) investigators have already (re) published new elaborations of results already reported and subsequently revised with in-depth descriptions of cardiovascular endpoints in women treated with a continuous combined schedule of conjugated equine estrogens (CEE) plus medroxyprogesterone acetate (MPA) or CEE alone in hysterectomized women . And now 5 years after the original WHI publication, a further report appears reprocessing the same database and information, focusing on age groups and time since menopause. Now they report that the so-called 'early arm' for cardiovascular disease is not applicable to women younger than 60 years. The WHI data now show that, in younger postmenopausal women within 10 years of menopause, the estimated absolute excess risk for coronary heart disease (CHD) is actually negative, ?6 per 10 000 person-years; thus, there is a reduction of CHD risk. Conversely, for women 10 to 19 years since menopause, the excess risk for CHD starts to increase (4 per 10 000 person-years) and for women 20 or more years from menopause excess risk goes up to 17 per 10 000 person-years. Analyzing the data according to chronological age the WHI investigators now recognize that the possible cardiovascular complications that can harm women do not apply to the age group 50-59 years, with a hazard ratio (HR) of 0.93 (95% confidence interval (CI) 0.65-1.33) and an absolute reduction of -2 cases per 10 000 person-years.