The Women's Health Initiative could not have detected cardioprotective effects of starting hormone therapy during the menopausal transition
Received 18 November 2003; received in revised form 25 February 2004; accepted 25 February 2004.
Abstract
The Women's Health Initiative (WHI) randomized controlled trial failed to show cardioprotection by estrogen plus progestin treatment of postmenopausal women. But by design, the WHI population was 10-fold underpowered to show cardioprotection of women starting hormone treatment during the menopausal transition. Thus, observational studies that showed cardioprotection in such women remain the only applicable clinical guide to this issue. Randomized controlled trials are urgently needed to test cardioprotection in women starting treatment during the menopausal transition.
aDepartment of Obstetrics, Gynecology and Reproductive Sciences, Yale University, New Haven, Connecticut, USA
bMolecular Cardiology Research Institute, Tufts-New England Medical Center, Boston, Massachusetts, USA
cDepartment of Internal Medicine, Carl T. Hayden VA Medical Center, Phoenix, Arizona, USA
dInstitute for Life-Span Development and Gerontology, University of Akron, Akron, Ohio, USA
eDepartment of Comparative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
fDepartment of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York, USA
gWomen's Heart Institute, Los Angeles, California, USA
hDepartment of Obstetrics and Gynecology, New York University School of Medicine, New York, New York, USA
iResearch and Development, The Kronos Group, Phoenix, Arizona, USA
jPhillips Ambulatory Care Center, Beth Israel Medical Center, New York, New York, USA
kVascular Medicine, Lenox Hill Hospital, New York, New York, USA
lKronos Longevity Research Institute, Phoenix, Arizona, USA
Reprint requests: Frederick Naftolin, M.D., Ph.D., Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University, P.O. Box 208063, New Haven, Connecticut 06520-8063 (FAX: 203-785-5294, USA)
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