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Menopausal HT & Risk of Long-Term All-Cause Mortality

JAMA; 2017 Sep 12; Manson, Aragaki, et al

Among postmenopausal women, hormone therapy (HT) for 5 to 7 years was not associated with risk of long-term all-cause, cardiovascular (CV) or cancer mortality, a recent study showed. The study included 27,347 women (aged 50 to 79 years) from 2 parallel randomized trials of estrogen plus progestin and estrogen alone between 1993 and 1998 and followed up through December 31, 2014. Participants were randomized to conjugate equine estrogens (CEE, 0.625 mg/d) plus medroxyprogresterone acetate (MPA, 2.5 mg/d) (n=8,506) vs placebo (n=8,102) for 5.6 years (median) or CEE alone (n=5,310) vs placebo (n=5,429) for 7.2 years (median). Researchers found:

  • 7,489 deaths occurred during the 18-year follow-up.
  • All-cause mortality was 27.1% in the hormone therapy group vs 27.6% in the placebo group (HR, 0.99) in the overall pooled cohort; with CEE plus MPA, the HR was 1.02 and with CEE alone, the HR was 0.94.
  • In the pooled cohort for CV mortality, the HR was 1.00; for total cancer mortality, HR was 1.03, and for other causes, the HR was 0.95.

Citation:

Manson JE, Aragaki AK, Rossouw JE, et al; for the WHI Investigators. Menopausal hormone therapy and long-term all-cause and cause-specific mortality. The Women’s Health Initiative Randomized Trials. JAMA. 2017;318(10):927–938. doi:10.1001/jama.2017.11217.