The table below summarizes the available evidence on the risks and benefits of hormone therapy.
Included are all randomized trials and meta-analyses looking at disease incidence or mortality. Inclusion of observational trials was dependent
on size: case-control studies with 500 or more cases of the disease and cohort studies with at least
2,000 women are included here.
The year noted is when the study results were published. The name following the title of the study is the last
name of the first author on the publication.
|
Year
|
Study
|
Study Type
|
Participants
|
Hormones
|
Results
|
Other Notes
|
|
1985
|
Framingham Heart Study, Wilson
|
Cohort
|
1,234
|
E
|
Increased risk 50%
|
8 years of follow-up
|
|
1987
|
Lipid Research Clinics Program Follow-up
Study, Bush
|
Cohort
|
2270
|
E
|
Decreased risk 63%
|
Average follow-up 8.5 years
|
|
1993
|
Rosenberg
|
Case-control
|
858 cases, 858 controls
|
E
|
No significant difference in risk
|
|
|
1996
|
Nurses' Health Study, Grodstein (A)
|
Cohort
|
59,337
|
E, E + P
|
E alone decreases risk 40%; E + P
decreases risk 39%
|
Up to 16 years follow-up
|
|
1997
|
Heckbert
|
Case-control
|
850 cases, 1,974 controls
|
E, E + P
|
8.2 years of hormone use decreases risk 45%
|
Risk decreased with duration of use; little difference between E and E + P
|
|
1997
|
Hemminki
|
Meta-analysis of randomized trials
|
22 studies, 4124 women
|
E, E+P
|
No statistically significant effect on
risk of cardiovascular events
|
No distinction between E and E + P
|
|
1998
|
Heart and Estrogen/progestin Replacement
Study (HERS), Hulley
|
Randomized
|
2,763
|
E + P
|
No effect over 4 years; 52% increased risk in the first year
|
Average follow-up 4.8 years; trial
participants had prior history of cardiovascular disease
|
|
1998
|
Sourander
|
Cohort
|
7,944
|
E
|
Current use decreases risk 79%; no
significant difference in former users
|
8 years of follow-up
|
|
1999
|
Grodstein (B)
|
Cohort
|
9,236
|
E, E + P
|
Decreases risk 25%
|
Results similar for E alone and E + P
|
|
2000
|
Varas-Lorenzo
|
Case-control
|
1,013 cases, 5,000 controls
|
E, E + P
|
Current use of E alone for > 1 year decreases risk 48%; current use of E + P for > 1 year decreases risk 21%
|
|
|
2000
|
Nurses' Health Study, Grodstein
|
Cohort
|
70,533
|
E, E + P
|
Hormone use decreases risk 39%
|
Participants had no prior history of
cardiovascular disease; no clear difference in risk between E alone and E + P
|
|
2001
|
Nurses' Health Study, Grodstein
|
Cohort
|
2,489
|
E, E + P
|
Short-term use (<1 year) increases
risk 25%; longer-term use decreases risk 62%
|
Average follow-up 6.9 years;
participants had prior history of cardiovascular disease; no difference
between E and E + P
|
|
2001
|
Shlipak
|
Cohort
|
114,724
|
E, E + P
|
Among women with myocardial infarction, hormone use reduced risk of mortality 35%
|
No distinction between E and E + P; all participants had myocardial infarction
|
|
2002
|
Heart and Estrogen/progestin Replacement
Study II (HERS),
Grady
|
Randomized
|
2,321
|
E + P
|
No overall difference in risk over 6.8
years follow-up
|
2.7 year extension of HERS with subset of
participants from original study; 6.8 years total follow-up; trial participants had prior history of cardiovascular
disease
|
|
2002
|
Women's Health Initiative
|
Randomized
|
16,608
|
E + P
|
Increases risk 29%
|
5.2 years of follow-up
|