Showing posts with label womens health initiative. Show all posts
Showing posts with label womens health initiative. Show all posts
Sunday, May 29, 2011
EvidenceUpdates + professional commentaries (numerous): Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women`s Health Initiative limited access dataset and meta-analysis
OBJECTIVES: To investigate the effects of personal calcium supplement use on cardiovascular risk in the Women`s Health Initiative Calcium/Vitamin D Supplementation Study (WHI CaD Study), using the WHI dataset, and to update the recent meta-analysis of calcium supplements and cardiovascular risk.
DESIGN: Reanalysis of WHI CaD Study limited access dataset and incorporation in meta-analysis with eight other studies.........
Conclusions: Calcium supplements with or without vitamin D modestly increase the risk of cardiovascular events, especially myocardial infarction, a finding obscured in the WHI CaD Study by the widespread use of personal calcium supplements. A reassessment of the role of calcium supplements in osteoporosis management is warranted.
add your opinions
calcium
,
cardio
,
cardiovascular
,
heart
,
post WHI
,
vitamin D
,
WHI
,
womens health initiative
Sunday, April 24, 2011
abstract: Health Outcomes After Stopping Conjugated Equine Estrogens Among Postmenopausal Women With Prior Hysterectomy — JAMA
Health Outcomes After Stopping Conjugated Equine Estrogens Among Postmenopausal Women With Prior Hysterectomy
A Randomized Controlled Trial
Abstract
Context
The Women's
Health Initiative Estrogen-Alone Trial was stopped early after a mean of
7.1 years of follow-up because of an
increased risk of stroke and little likelihood of
altering the balance of risk to benefit by the planned trial termination
date. Postintervention health outcomes have not
been reported.
Objective
To examine health outcomes associated with randomization to treatment with conjugated equine estrogens (CEE) among women
with prior hysterectomy after a mean of 10.7 years of follow-up through August 2009.
Design, Setting, and Participants
The intervention phase was a double-blind, placebo-controlled,
randomized clinical trial of 0.625 mg/d of CEE compared with
placebo in 10 739 US postmenopausal women aged 50
to 79 years with prior hysterectomy. Follow-up continued after the
planned
trial completion date among 7645 surviving
participants (78%) who provided written consent.
Main Outcome Measures
The
primary outcomes were coronary heart disease (CHD) and invasive breast
cancer. A global index of risks and benefits included
these primary outcomes plus stroke, pulmonary
embolism, colorectal cancer, hip fracture, and death.
Results
The
postintervention risk (annualized rate) for CHD among women assigned to
CEE was 0.64% compared with 0.67% in the placebo
group (hazard ratio [HR], 0.97; 95% confidence
interval [CI], 0.75-1.25), 0.26% vs 0.34%, respectively, for breast
cancer
(HR, 0.75; 95% CI, 0.51-1.09), and 1.47% vs 1.48%,
respectively, for total mortality (HR, 1.00; 95% CI, 0.84-1.18). The
risk
of stroke was no longer elevated during the
postintervention follow-up period and was 0.36% among women receiving
CEE compared
with 0.41% in the placebo group (HR, 0.89; 95% CI,
0.64-1.24), the risk of deep vein thrombosis was lower at 0.17% vs
0.27%,
respectively (HR, 0.63; 95% CI, 0.41-0.98), and the
risk of hip fracture did not differ significantly and was 0.36% vs
0.28%,
respectively (HR, 1.27; 95% CI, 0.88-1.82). Over
the entire follow-up, lower breast cancer incidence in the CEE group
persisted
and was 0.27% compared with 0.35% in the placebo
group (HR, 0.77; 95% CI, 0.62-0.95). Health outcomes were more favorable
for younger compared with older women for CHD (P = .05 for interaction), total myocardial infarction (P = .007 for interaction), colorectal cancer (P = .04 for interaction), total mortality (P = .04 for interaction), and global index of chronic diseases (P = .009 for interaction).
Conclusions
Among
postmenopausal women with prior hysterectomy followed up for 10.7 years,
CEE use for a median of 5.9 years was not
associated with an increased or decreased risk of
CHD, deep vein thrombosis, stroke, hip fracture, colorectal cancer, or
total
mortality.
A decreased risk of breast cancer
persisted.
add your opinions
estrogen
,
HRT
,
outcomes
,
post WHI
,
womens health initiative
Wednesday, December 29, 2010
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