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U.S. Preventive Services Task Force


Menopausal Hormone Therapy for the Primary Prevention of Chronic Conditions (continued)

Table 2. Results of the Women's Health Initiative Trials

Outcome Estrogen Plus Progestin Versus Placebo Estrogen-Only Versus Placebo
Hazard Ratio (95% CI) Reference Difference in events per
10,000 women-years (95% CI)*
Hazard Ratio (95% CI) Reference Difference in events per
10,000 women-years (95% CI)*
Cancer
   Invasive breast 1.25 (1.07–1.46) 18 8 (3–14) more 0.77 (0.62–0.95) 34 8 (1–14) fewer
   Colorectal 0.75 (0.57–1.00) 28 1.11 (0.82–1.50)§ 34
   Lung 1.23 (0.92–1.63) 21 1.17 (0.81–1.69) 19
   Endometrial 0.78 (0.52–1.16)§ 28 Not reported  
   Ovarian 1.58 (0.77–3.24) 14 Not reported  
   Cervical 1.44 (0.47–4.42) 14 Not reported  
Cardiovascular events
   Coronary heart disease|| 1.22 (0.99–1.51) 28 0.95 (0.78–1.15)§ 34
   Stroke 1.34 (1.05–1.71)§ 28 9 (2–15) more 1.36 (1.08–1.71)§ 34 11 (2–20) more
Thromboembolic events
   Deep venous thrombosis 1.88 (1.38–2.55)§ 28 12 (6–17) more 1.47 (1.06–2.05)§ 34 7 (1–14) more
   Pulmonary embolism 1.98 (1.36–2.87)§ 28 9 (4–14) more 1.37 (0.90–2.07)§ 34
Diabetes 0.79 (0.67–0.93) 36 15 (4–26) fewer 0.88 (0.77–1.01) 15
Fractures
   Hip 0.67 (0.47–0.95)§ 28 6 (1–10) fewer 0.61 (0.41–0.91) 2 7 (1–12) fewer
   Vertebral 0.68 (0.48–0.96)§ 28 6 (1–11) fewer 0.62 (0.42–0.93) 2 6 (1–12) fewer
   Total** 0.76 (0.69–0.83)§ 28 46 (29–63) fewer 0.70 (0.63–0.79) 2 56 (37–75) fewer
Mortality
    All-cause 1.04 (0.91–1.18)§ 28 1.02 (0.91–1.15)§ 34
   Breast cancer 1.96 (1.00–4.04) 18 0.37 (0.13–0.91) 63 2 (1–3) fewer
    Lung cancer 1.71 (1.16–2.52) 21 5 (1–8) more Not reported  
Gallbladder disease†† 1.61 (1.30–2.00) 23 20 (11–29) more 1.79 (1.44–2.22) 23 33 (20–45) more
Cognitive function
   Probable dementia 2.05 (1.21–3.48) 45 22 (5–39) more 1.49 (0.83–2.66) 44
   Mild impairment 1.07 (0.74–1.55) 45 1.34 (0.95–1.89) 44
Urinary incontinence‡‡ 1.39 (1.27–1.52) 30 872 (591–1153) more 1.53 (1.37–1.71) 30 1271 (883–1660) more

*Assumes a constant rate of events across the study period, although rates actually varied by outcome (e.g., thromboembolic events occurred early during therapy whereas cases of cancer occurred later).
† Updated results are statistically significant, initial results were not.
‡ Updated results are not statistically significant, initial results were.
§ Updated results are similar to initial results.
|| Myocardial infarctions and death from coronary heart disease.
Self-reported new diagnosis requiring treatment with drugs.
** Includes all reported clinical fractures except fractures of the ribs, chest or sternum, skull or face, fingers, toes, and cervical vertebrae.
†† Cholecystitis or cholelithiasis.
‡‡ Stress, urge, or mixed urinary incontinence.

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