For decades, women have been using hormone replacement therapy (HRT) to combat the adverse effects of menopause such as osteoporosis and heart disease (Hlatky, Boothroyd, Vittinghoff, Sharp and Whooley, 2002). HRT has also been thought to help prevent hip fractures, stroke and myocardial infarction, as well as prevent hot flashes and depression associated with menopause. Surveys have shown that roughly 36 percent of postmenopausal American women between the ages of 50 and 74 take HRT (Hlatky, et al., 2002). This year, on July 17, the Journal of the American Medical Association published the results of the WomenÆs Health Initiative randomized controlled study on the risks and benefits of estrogen plus progestin hormone replacement therapy in otherwise healthy postmenopausal women (Risks and benefits, 2002). The study shattered previous conceptions about the benefits of such replacement therapy by its findings that the use of such therapy resulted in an increased risk of cardiovascular disease and breast cancer in these women.
The evidence resulted in the termination of the large study involving over 16,000 women evaluating the benefits and risks of HRT for prevention of CAD in postmenopausal women because of a finding of a 26 percent increase in the risk of invasive breast cancer caused by the treatment (Wooten, 2002). The study was halted five years into its 8+-year course. The drug being used (Prempro) also caused a 41 percent increase in the risk of stroke, a 29 percent increase in the risk of coronary heart disease (CHD), and doubled the risk of pulmonary embolism. It was determined that the overall health risks of the study far outweighed the benefits of the HRT, and though all-cause mortality was unaffected by the study, HRT was deemed inconsistent with ôthe requirements for a viable intervention for primary prevention of chronic diseasesö (CHD) (Risks and benefits, 2002).
Hlatky, Boothroyd and Vittingho...