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

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Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Gynaecology ★★★★★★★ Cardiology ★★★★★☆☆ IM/Ambulatory care ★★★★★☆☆

METHODS

Embedded ImageDesign:

2 randomised placebo-controlled trials (Women’s Health Initiative [WHI] trials).

Embedded ImageAllocation:

{concealed}*.

Embedded ImageBlinding:

blinded {clinicians, participants, data collectors, outcome assessors, and monitoring committee}*.

Embedded ImageFollow-up period:

mean 5.6 and 7.1§ years.

Embedded ImageSetting:

40 US clinical centres.

Embedded ImageParticipants:

27 347 predominantly healthy postmenopausal women 50–79 years of age (mean age 63* and 64|| y).

Embedded ImageIntervention

conjugated equine oestrogen (CEO), 0.625 mg/day, plus medroxyprogesterone acetate, 2.5 mg/day (n = 8506), or placebo (n = 8102) in women with an intact uterus; CEO, 0.625 mg/day (n = 5310), or placebo (n = 5429) in women with a hysterectomy.

Embedded ImageOutcomes:

coronary heart disease (CHD) (myocardial infarction or CHD death), stroke, total mortality, and a global index.

Embedded ImageParticipant follow-up:

94%|| (intention-to-treat analysis).

MAIN RESULTS

Overall, the HT and placebo groups did not differ for CHD, total mortality, and the global index; the risk of stroke was higher in the HT group …

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