| 000 | 05538nam a22007817a 4500 | ||
|---|---|---|---|
| 008 | 240807s20242024 xxu||||| |||| 00| 0 eng d | ||
| 022 | _a0098-7484 | ||
| 024 | _a2818206 [pii] | ||
| 040 | _aOvid MEDLINE(R) | ||
| 099 | _a38691368 | ||
| 245 | _aThe Women's Health Initiative Randomized Trials and Clinical Practice: A Review. [Review] | ||
| 251 | _aJAMA. 331(20):1748-1760, 2024 05 28. | ||
| 252 | _aJAMA. 331(20):1748-1760, 2024 05 28. | ||
| 253 | _aJAMA | ||
| 260 | _c2024 | ||
| 260 | _fFY2024 | ||
| 260 | _p2024 05 28 | ||
| 265 | _sppublish | ||
| 265 | _tMEDLINE | ||
| 266 | _d2024-08-07 | ||
| 266 | _z2024/05/01 11:33 | ||
| 501 | _aAvailable online from MWHC library: 1998 - present, Available in print through MWHC library: 1999 - present | ||
| 520 | _aConclusions and Relevance: For postmenopausal women, the WHI randomized clinical trials do not support menopausal hormone therapy to prevent cardiovascular disease or other chronic diseases. Menopausal hormone therapy is appropriate to treat bothersome vasomotor symptoms among women in early menopause, without contraindications, who are interested in taking hormone therapy. The WHI evidence does not support routine supplementation with calcium plus vitamin D for menopausal women to prevent fractures or a low-fat diet with increased fruits, vegetables, and grains to prevent breast or colorectal cancer. A potential role of a low-fat dietary pattern in reducing breast cancer mortality, a secondary outcome, warrants further study. | ||
| 520 | _aImportance: Approximately 55 million people in the US and approximately 1.1 billion people worldwide are postmenopausal women. To inform clinical practice about the health effects of menopausal hormone therapy, calcium plus vitamin D supplementation, and a low-fat dietary pattern, the Women's Health Initiative (WHI) enrolled 161808 postmenopausal US women (N = 68132 in the clinical trials) aged 50 to 79 years at baseline from 1993 to 1998, and followed them up for up to 20 years. | ||
| 520 | _aObservations: The WHI clinical trial results do not support hormone therapy with oral conjugated equine estrogens plus medroxyprogesterone acetate for postmenopausal women or conjugated equine estrogens alone for those with prior hysterectomy to prevent cardiovascular disease, dementia, or other chronic diseases. However, hormone therapy is effective for treating moderate to severe vasomotor and other menopausal symptoms. These benefits of hormone therapy in early menopause, combined with lower rates of adverse effects of hormone therapy in early compared with later menopause, support initiation of hormone therapy before age 60 years for women without contraindications to hormone therapy who have bothersome menopausal symptoms. The WHI results do not support routinely recommending calcium plus vitamin D supplementation for fracture prevention in all postmenopausal women. However, calcium and vitamin D are appropriate for women who do not meet national guidelines for recommended intakes of these nutrients through diet. A low-fat dietary pattern with increased fruit, vegetable, and grain consumption did not prevent the primary outcomes of breast or colorectal cancer but was associated with lower rates of the secondary outcome of breast cancer mortality during long-term follow-up. | ||
| 546 | _aEnglish | ||
| 650 | _a*Breast Neoplasms | ||
| 650 | _a*Cardiovascular Diseases | ||
| 650 | _a*Dietary Supplements | ||
| 650 | _a*Estrogen Replacement Therapy | ||
| 650 | _a*Women's Health | ||
| 650 | _aAged | ||
| 650 | _aBreast Neoplasms/pc [Prevention & Control] | ||
| 650 | _aCalcium, Dietary/ad [Administration & Dosage] | ||
| 650 | _aCalcium/ad [Administration & Dosage] | ||
| 650 | _aCalcium/tu [Therapeutic Use] | ||
| 650 | _aCardiovascular Diseases/pc [Prevention & Control] | ||
| 650 | _aDiet, Fat-Restricted | ||
| 650 | _aEstrogen Replacement Therapy/ae [Adverse Effects] | ||
| 650 | _aEstrogens, Conjugated (USP)/ad [Administration & Dosage] | ||
| 650 | _aEstrogens, Conjugated (USP)/ae [Adverse Effects] | ||
| 650 | _aEstrogens, Conjugated (USP)/tu [Therapeutic Use] | ||
| 650 | _aFemale | ||
| 650 | _aHot Flashes/dt [Drug Therapy] | ||
| 650 | _aHumans | ||
| 650 | _aMedroxyprogesterone Acetate/ad [Administration & Dosage] | ||
| 650 | _aMedroxyprogesterone Acetate/ae [Adverse Effects] | ||
| 650 | _aMedroxyprogesterone Acetate/tu [Therapeutic Use] | ||
| 650 | _aMiddle Aged | ||
| 650 | _aOsteoporosis, Postmenopausal/dt [Drug Therapy] | ||
| 650 | _aOsteoporosis, Postmenopausal/pc [Prevention & Control] | ||
| 650 | _aPostmenopause | ||
| 650 | _aRandomized Controlled Trials as Topic | ||
| 650 | _aUnited States | ||
| 650 | _aVitamin D/ad [Administration & Dosage] | ||
| 650 | _aVitamin D/tu [Therapeutic Use] | ||
| 650 | _zCurated | ||
| 651 | _aMedStar Health Research Institute | ||
| 657 | _aJournal Article | ||
| 657 | _aResearch Support, N.I.H., Extramural | ||
| 657 | _aResearch Support, Non-U.S. Gov't | ||
| 657 | _aResearch Support, U.S. Gov't, P.H.S. | ||
| 657 | _aReview | ||
| 700 |
_aHoward, Barbara V _bMHRI |
||
| 790 | _aManson JE, Crandall CJ, Rossouw JE, Chlebowski RT, Anderson GL, Stefanick ML, Aragaki AK, Cauley JA, Wells GL, LaCroix AZ, Thomson CA, Neuhouser ML, Van Horn L, Kooperberg C, Howard BV, Tinker LF, Wactawski-Wende J, Shumaker SA, Prentice RL | ||
| 856 |
_uhttps://dx.doi.org/10.1001/jama.2024.6542 _zhttps://dx.doi.org/10.1001/jama.2024.6542 |
||
| 942 |
_cART _dArticle |
||
| 999 |
_c14588 _d14588 |
||