Oestrogen plus progestin increased coronary heart disease and breast cancer in postmenopausal women
QUESTION: In postmenopausal women, what are the risks and benefits of oestrogen plus progestin use, particularly with respect to coronary heart disease (CHD) events?
Randomised (allocation concealed), blinded (clinicians, participants, data collectors, outcome assessors, and monitoring committee), placebo controlled trial with a mean 5.2 years of follow up.
40 US clinical centres.
16 608 postmenopausal women who were 50–79 years of age (mean age 63.3 y) with an intact uterus at baseline. Exclusion criteria included medical conditions associated with probable survival of <3 years, previous breast cancer or other cancer in the past 10 years (except non-melanoma skin cancer), low hematocrit or platelet counts, and adherence and retention concerns (eg, alcoholism and dementia). Follow up was 96.5%.
Women were allocated to 1 daily tablet of conjugated equine oestrogen, 0.625 mg, and medroxyprogesterone acetate, 2.5 …