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Oestrogen therapy increased stroke risk and decreased hip fracture risk but did not affect coronary heart disease risk in postmenopausal women with prior hysterectomy

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 Q In postmenopausal women with prior hysterectomy, what is the effect of conjugated equine oestrogen (CEE) on major disease rates?

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


Embedded ImageDesign:

randomised placebo controlled trial (Women’s Health Initiative [WHI]).

Embedded ImageAllocation:


Embedded ImageBlinding:

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

Embedded ImageFollow up period:

mean 6.8 years.

Embedded ImageSetting:

40 US clinical centres.

Embedded ImageParticipants:

10 739 postmenopausal women aged 50–79 years (mean age 64 y, 75% white) with prior hysterectomy. Exclusion criteria included probable survival <3 years and breast cancer.

Embedded ImageIntervention:

CEE, 0.625 mg/day (n = 5310); or matching placebo (n = 5429).

Embedded ImageOutcomes:

incidences of coronary heart disease (CHD) (defined as CHD death or non-fatal myocardial infarction), …

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  • * See glossary.

  • Information provided by author.

  • For correspondence: Dr G L Anderson, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.

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