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Although
hormone-replacement therapy decreased LDL-C by 11% and increased HDL-C by 10% compared
with placebo, at a mean follow-up of 4 years neither the primary endpoint nor any of the
secondary endpoints were significantly different between treatment groups. Relative hazard
of nonfatal myocardial infarction was slightly decreased and relative hazard of CHD death
was slightly increased with hormone treatment, but the differences were not statistically
significant. However, there was a statistically significant trend for more CHD events with
hormone treatment in year 1 and fewer events in years 4 and 5. Hormone treatment also
increased risk for venous thromboembolic events (deep vein thrombosis [DVT] or pulmonary
embolism [PE]) and gall bladder disease. Reference:
Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B, Vittinghoff E, for the Heart
and Estrogen/progestin Replacement Study (HERS) Research Group. Randomized trial of
estrogen plus progestin for secondary prevention of coronary heart disease in
postmenopausal women. JAMA 1998;280:605-613. |