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Postmenopausal Hormone Use and Secondary Prevention of Coronary Events in the Nurses' Health Study: A Prospective, Observational Study

Francine Grodstein, ScD; JoAnn E. Manson, MD; and Meir J. Stampfer, MD
[+] Article, Author, and Disclosure Information

From Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, and Harvard School of Public Health, Boston, Massachusetts.

Acknowledgment: The authors thank Drs. Frank Speizer and Graham Colditz for their support.

Grant Support: By grants CA40356 and HL34594 from the National Institutes of Health. Dr. Grodstein is partially supported by grant AG13482 from the National Institute of Aging and a New Scholars Award from the Ellison Medical Foundation.

Requests for Single Reprints: Francine Grodstein, ScD, Channing Laboratory, 181 Longwood Avenue, Boston, MA 02115.

Current Author Addresses: Dr. Grodstein: Channing Laboratory, 181 Longwood Avenue, Boston, MA 02115.

Dr. Manson: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, 900 Commonwealth Avenue East, Boston, MA 02215.

Dr. Stampfer: Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115.

Author Contributions: Conception and design: F. Grodstein, J.E. Manson, M.J. Stampfer.

Analysis and interpretation of the data: F. Grodstein, J.E. Manson, M.J. Stampfer.

Drafting of the article: F. Grodstein.

Critical revision of the article for important intellectual content: J.E. Manson, M.J. Stampfer.

Final approval of the article: F. Grodstein, J.E. Manson, M.J. Stampfer.

Statistical expertise: F. Grodstein, M.J. Stampfer.

Obtaining of funding: J.E. Manson.

Administrative, technical, or logistic support: F. Grodstein, J.E. Manson, M.J. Stampfer.

Collection and assembly of data: F. Grodstein, J.E. Manson.

Ann Intern Med. 2001;135(1):1-8. doi:10.7326/0003-4819-135-1-200107030-00003
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The Heart and Estrogen/progestin Replacement Study (HERS) was a randomized clinical trial of postmenopausal hormone use in 2763 women (1). Unlike previous observational studies, it included only women with previous coronary heart disease, and hormone therapy was exclusively oral conjugated estrogen plus progestin. In HERS, overall rates of recurrent coronary heart disease did not differ between the treated and nontreated groups. However, in additional, unplanned analyses, the results of HERS were not uniformly null. A marked and statistically significant trend toward decreasing risk was observed with increasing duration of hormone use (1); in the first year, the rate of major coronary events was 52% higher in the treatment group. In the second year, rates were equal, but during the final fourth and fifth years, women assigned to hormone therapy had a 33% lower risk for coronary events.

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Summary for Patients

In Some Women, Postmenopausal Hormone Use Increases Short-Term Risk for Heart Disease, but Decreases Risk in the Long Term

The summary below is from the full report titled “Postmenopausal Hormone Use and Secondary Prevention of Coronary Events in the Nurses' Health Study. A Prospective, Observational Study.” It is in the 3 July 2001 issue of Annals of Internal Medicine (volume 135, pages 1-8). The authors are F Grodstein, JE Manson, and MJ Stampfer.


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