Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women's Health Initiative randomized trials. (Record no. 405)

000 -LEADER
fixed length control field 06627nam a22010817a 4500
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
fixed length control field 131223s20132013 xxu||||| |||| 00| 0 eng d
040 ## - CATALOGING SOURCE
Original cataloging agency Ovid MEDLINE(R)
099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC)
Classification number 24084921
022 ## - INTERNATIONAL STANDARD SERIAL NUMBER
International Standard Serial Number 0098-7484
190 ## -
-- Manson JE
190 ## -
-- Chlebowski RT
190 ## -
-- Stefanick ML
190 ## -
-- Aragaki AK
190 ## -
-- Rossouw JE
190 ## -
-- Prentice RL
190 ## -
-- Anderson G
190 ## -
-- Howard BV
190 ## -
-- Thomson CA
190 ## -
-- LaCroix AZ
190 ## -
-- Wactawski-Wende J
190 ## -
-- Jackson RD
190 ## -
-- Limacher M
190 ## -
-- Margolis KL
190 ## -
-- Wassertheil-Smoller S
190 ## -
-- Beresford SA
190 ## -
-- Cauley JA
190 ## -
-- Eaton CB
190 ## -
-- Gass M
190 ## -
-- Hsia J
190 ## -
-- Johnson KC
190 ## -
-- Kooperberg C
190 ## -
-- Kuller LH
190 ## -
-- Lewis CE
190 ## -
-- Liu S
190 ## -
-- Martin LW
190 ## -
-- Ockene JK
190 ## -
-- O'Sullivan MJ
190 ## -
-- Powell LH
190 ## -
-- Simon MS
190 ## -
-- Van Horn L
190 ## -
-- Vitolins MZ
190 ## -
-- Wallace RB
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Howard, Barbara V
245 ## - TITLE STATEMENT
Title Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women's Health Initiative randomized trials.
251 ## -
-- JAMA. 310(13):1353-68, 2013 Oct 2.
252 ## -
-- JAMA. 310(13):1353-68, 2013 Oct 2.
253 ## -
-- JAMA : the journal of the American Medical Association
501 ## - WITH NOTE
With note Available online from MWHC library: 1998 - present, Available in print through MWHC library: 1999 - present
520 ## - SUMMARY, ETC.
Summary, etc. IMPORTANCE: Menopausal hormone therapy continues in clinical use but questions remain regarding its risks and benefits for chronic disease prevention.
520 ## - SUMMARY, ETC.
Summary, etc. OBJECTIVE: To report a comprehensive, integrated overview of findings from the 2 Women's Health Initiative (WHI) hormone therapy trials with extended postintervention follow-up.
520 ## - SUMMARY, ETC.
Summary, etc. DESIGN, SETTING, AND PARTICIPANTS: A total of 27,347 postmenopausal women aged 50 to 79 years were enrolled at 40 US centers.
520 ## - SUMMARY, ETC.
Summary, etc. INTERVENTIONS: Women with an intact uterus received conjugated equine estrogens (CEE; 0.625 mg/d) plus medroxyprogesterone acetate (MPA; 2.5 mg/d) (n=8506) or placebo (n=8102). Women with prior hysterectomy received CEE alone (0.625 mg/d) (n=5310) or placebo (n=5429). The intervention lasted a median of 5.6 years in CEE plus MPA trial and 7.2 years in CEE alone trial with 13 years of cumulative follow-up until September 30, 2010.
520 ## - SUMMARY, ETC.
Summary, etc. MAIN OUTCOMES AND MEASURES: Primary efficacy and safety outcomes were coronary heart disease (CHD) and invasive breast cancer, respectively. A global index also included stroke, pulmonary embolism, colorectal cancer, endometrial cancer, hip fracture, and death.
520 ## - SUMMARY, ETC.
Summary, etc. RESULTS: During the CEE plus MPA intervention phase, the numbers of CHD cases were 196 for CEE plus MPA vs 159 for placebo (hazard ratio [HR], 1.18; 95% CI, 0.95-1.45) and 206 vs 155, respectively, for invasive breast cancer (HR, 1.24; 95% CI, 1.01-1.53). Other risks included increased stroke, pulmonary embolism, dementia (in women aged >=65 years), gallbladder disease, and urinary incontinence; benefits included decreased hip fractures, diabetes, and vasomotor symptoms. Most risks and benefits dissipated postintervention, although some elevation in breast cancer risk persisted during cumulative follow-up (434 cases for CEE plus MPA vs 323 for placebo; HR, 1.28 [95% CI, 1.11-1.48]). The risks and benefits were more balanced during the CEE alone intervention with 204 CHD cases for CEE alone vs 222 cases for placebo (HR, 0.94; 95% CI, 0.78-1.14) and 104 vs 135, respectively, for invasive breast cancer (HR, 0.79; 95% CI, 0.61-1.02); cumulatively, there were 168 vs 216, respectively, cases of breast cancer diagnosed (HR, 0.79; 95% CI, 0.65-0.97). Results for other outcomes were similar to CEE plus MPA. Neither regimen affected all-cause mortality. For CEE alone, younger women (aged 50-59 years) had more favorable results for all-cause mortality, myocardial infarction, and the global index (nominal P<.05 for trend by age). Absolute risks of adverse events (measured by the global index) per 10,000 women annually taking CEE plus MPA ranged from 12 excess cases for ages of 50-59 years to 38 for ages of 70-79 years; for women taking CEE alone, from 19 fewer cases for ages of 50-59 years to 51 excess cases for ages of 70-79 years. Quality-of-life outcomes had mixed results in both trials.
520 ## - SUMMARY, ETC.
Summary, etc. CONCLUSIONS AND RELEVANCE: Menopausal hormone therapy has a complex pattern of risks and benefits. Findings from the intervention and extended postintervention follow-up of the 2 WHI hormone therapy trials do not support use of this therapy for chronic disease prevention, although it is appropriate for symptom management in some women.
520 ## - SUMMARY, ETC.
Summary, etc. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00000611.
546 ## - LANGUAGE NOTE
Language note English
651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME
Geographic name MedStar Health Research Institute
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Aged
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Breast Neoplasms/ep [Epidemiology]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Breast Neoplasms/pc [Prevention & Control]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Colorectal Neoplasms/ep [Epidemiology]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Coronary Disease/ep [Epidemiology]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Coronary Disease/pc [Prevention & Control]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Drug Therapy, Combination
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Endometrial Neoplasms/ep [Epidemiology]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Estrogens/ad [Administration & Dosage]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Estrogens/ae [Adverse Effects]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Estrogens, Conjugated (USP)/ad [Administration & Dosage]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Estrogens, Conjugated (USP)/ae [Adverse Effects]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Female
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Follow-Up Studies
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Hip Fractures/ep [Epidemiology]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Hormone Replacement Therapy/ae [Adverse Effects]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Humans
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Medroxyprogesterone Acetate/ad [Administration & Dosage]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Medroxyprogesterone Acetate/ae [Adverse Effects]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Middle Aged
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Postmenopause
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Pulmonary Embolism/ep [Epidemiology]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Quality of Life
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Risk
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Stroke/ep [Epidemiology]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Treatment Outcome
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element United States/ep [Epidemiology]
657 ## - INDEX TERM--FUNCTION
Function Journal Article
657 ## - INDEX TERM--FUNCTION
Function Multicenter Study
657 ## - INDEX TERM--FUNCTION
Function Randomized Controlled Trial
657 ## - INDEX TERM--FUNCTION
Function Research Support, N.I.H., Intramural
857 ## -
-- http://dx.doi.org/10.1001/jama.2013.278040
856 ## - ELECTRONIC LOCATION AND ACCESS
Uniform Resource Identifier http://jama.jamanetwork.com/article.aspx?articleid=1745676
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Koha item type Journal Article
Holdings
Withdrawn status Lost status Damaged status Not for loan Collection code Permanent Location Current Location Date acquired Barcode Date last seen Price effective from Koha item type
          MedStar Authors Catalog MedStar Authors Catalog 2013-12-24 24084921 2013-12-24 2013-12-24 Journal Article

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