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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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