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Randomized Trial of Estrogen Plus Progestin for Secondary Prevention of Coronary Heart Disease in Postmenopausal Women

JAMA · 1998 · Vol. 280(7) · pp. 605–605
Stephen B. Hulley

Abstract

During an average follow-up of 4.1 years, treatment with oral conjugated equine estrogen plus medroxyprogesterone acetate did not reduce the overall rate of CHD events in postmenopausal women with established coronary disease. The treatment did increase the rate of thromboembolic events and gallbladder disease. Based on the finding of no overall cardiovascular benefit and a pattern of early increase in risk of CHD events, we do not recommend starting this treatment for the purpose of secondary prevention of CHD. However, given the favorable pattern of CHD events after several years of therapy, it could be appropriate for women already receiving this treatment to continue.

Menopause: Health Impacts and TreatmentsEstrogen and related hormone effectsSex and Gender in HealthcareMedicineMedroxyprogesterone acetateMyocardial infarctionHazard ratioInternal medicineUnstable anginaPlaceboRandomized controlled trialCardiologyCoronary artery disease

MeSH terms

AgedCoronary DiseaseDouble-Blind MethodDrug CombinationsEstrogens, Conjugated (USP)FemaleFollow-Up StudiesHumansLipoproteinsMiddle AgedRiskEstrogen Replacement TherapyProportional Hazards ModelsSurvival AnalysisMedroxyprogesterone Acetate
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