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Therapeutics
Oestrogen plus progestogen did not reduce the risk of coronary heart disease in postmenopausal women

https://doi.org/10.1136/ebm.9.2.52

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    Manson JE, Hsia J, Johnson KC, et al. Estrogen plus progestin and the risk of coronary heart disease. N Engl J Med 2003;349:523–34.
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 Q In postmenopausal women, how does oestrogen plus progestogen influence the risk of coronary heart disease (CHD)?

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

    METHODS

    Embedded ImageDesign:

    randomised placebo controlled trial.

    Embedded ImageAllocation:

    {concealed}*.†

    Embedded ImageBlinding:

    blinded (clinicians, participants, data collectors, outcome assessors, and monitoring committee).†

    Embedded ImageFollow up period:

    5.6 years (Women’s Health Initiative [WHI]).

    Embedded ImageSetting:

    {40 US clinical centres}*.

    Embedded ImagePatients:

    16 608 postmenopausal women who were 50–79 years of age (mean age 63 y), had an intact uterus, and resided in the same geographic area for ⩾3 years.

    Embedded ImageInterventions:

    patients were allocated to oral conjugated equine oestrogen, 0.625 mg/day, plus medroxyprogesterone acetate, 2.5 mg/day (n = 8506), or placebo (n = 8102).

    Embedded ImageOutcomes:

    CHD (ie, acute myocardial infarction [MI] requiring overnight hospital admission; death …

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    Footnotes

    • ↵*

      Writing Group for the Women’s Health Initiative Investigators. JAMA. 2002;288:321–33.
      OpenUrlCrossRefPubMedWeb of Science

    • ↵† See glossary.

    • For correspondence: Dr J E Manson, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA. jmansonrics.bwh.harvard.edu

    • Source of funding: National Heart, Lung and Blood Institute.

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      BMJ Publishing Group Ltd
      BMJ Evidence-Based Medicine 2004; 9 64-64 Published Online First: 16 Apr 2004. doi: 10.1136/ebm.9.2.64