Inflammatory, Lipid, Thrombotic, and Genetic Markers of Coronary Heart Disease Risk in the Women's Health Initiative Trials of Hormone Therapy

Abstract

The Women's Health Initiative (WHI) trials of postmenopausal hormone therapy (HT) tested whether the use of estrogen alone or combined with progestin would reduce the risk of coronary heart disease (CHD) in predominantly healthy postmenopausal women. The trial of conjugated equine estrogens plus medroxyprogesterone acetate in women with an intact uterus was stopped early because of an increase in cardiovascular events (CHD, stroke, and venous thromboembolism [VTE]) and in breast cancer.¹ The parallel trial of conjugated equine estrogens alone in hysterectomized women was also stopped early because of increased strokes and lack of benefit for CHD.² After publication of these findings, current recommendations state that HT should not be started or continued for the prevention of CHD.³