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More Evidence, More Pessimism

Diana B. Petitti, MD

JAMA. 2002;288:99-101.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Most physicians and researchers were surprised by the results of the Heart and Estrogen/progestin Replacement Study (HERS).¹ This randomized trial assessed the efficacy of hormone replacement for secondary prevention of coronary heart disease (CHD)—that is, the ability of hormone replacement therapy (HRT) to prevent CHD events in women with established coronary disease. After an average of 4.1 years of follow-up, there was no overall difference in CHD end points between women randomized to receive placebo or HRT given as a continuous combined regimen of 0.625 mg/d of estrogen plus 2.5 mg of medroxyprogesterone acetate.

However, when these results were reported, based on a trend of decreasing risk of CHD events with increasing duration of HRT use, the HERS authors speculated that the HERS results were a consequence of domination of the antiatherogenic effects of HRT by its early thrombotic effects.¹ The implication was that a net . . . [Full Text of this Article]

Author Affiliation: Research and Evaluation, Kaiser Permanente Southern California, Pasadena.

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