In contrast, WHI
participants were older (median age 63 years) and a majority (64%-82%) were >10 years postmenopausal.
Now, with 18 years of cumulative follow-up data available (intervention and extended postintervention phases), the WHI
investigators present all-cause and cause-specific mortality outcomes from the 2 HT trials.
The final analysis on HRT use from the WHI
study led investigators to reaffirm their earlier conclusion that HRT is not recommended for the prevention of chronic disease--but they also found that HRT is a reasonable treatment option for the short-term management of menopausal symptoms in some women.
A decade later, the WHI
results have turned out to be more complex than they appeared.
failures to maintain an effective written conflicts of interest policy, and inadequate recording of the kinds of service or activity carried out by WHI
in which a conflict of interest had arisen or may arise
The greatest risk was seen in breast cancer patients who at WHI
enrollment were current smokers with an additional cardiovascular risk factor.
This was always a faulty foundation for a study because the average age of menopause is 51 and the WHI
had already studied more than 5,000 women in their 50s--and found no such benefits.
That is what turned on the light bulb for Cheung, who used the WHI
data for this study.
The average age of the original WHI
study group was 63--a decade older than most women taking HRT.
As emphasised throughout the first report,  the WHI
trial was not designed to test the diet-heart hypothesis.
The use of estrogen therapy (ET) has been on a steady decline since 2002, when the Women's Health Initiative (WHI
) halted its trial of estrogen plus progestin because of adverse events, which sent shockwaves among women and the medical community.