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Oestrogen plus progestin increased coronary heart disease and breast cancer in postmenopausal women

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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 …

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  • For correspondence: Dr J E Rossouw, Division of Women’s Health Initiative, National Heart, Lung, and Blood Institute, Bethesda, MD, USA. rossouw{at}

  • A modified version of this abstract appears in ACP Journal Club and Evidence-Based Medicine.

  • Sources of funding: National Heart, Lung and Blood Institute and Wyeth-Ayerst Research.