Journal
AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY
Volume 313, Issue 5, Pages H1013-H1021Publisher
AMER PHYSIOLOGICAL SOC
DOI: 10.1152/ajpheart.00383.2017
Keywords
conjugated equine estrogen; 17 beta-estradiol; Early Versus Late Intervention Trial; Kronos Early Estrogen Prevention Study; timing hypothesis; Women's Health Initiative
Funding
- Aurora Foundation
- Mayo Foundation
- National Institute on Aging Grant [P50 AG-44170]
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The worlds of observational, clinical, and basic science collided in 2002 with the publication of results of the Women's Health Initiative (WHI), a large-scale, prospective, blinded, randomized-controlled trial designed to provide evidence regarding use of hormone treatment to prevent cardiovascular disease in menopausal women. The results of the WHI dramatically changed clinical practice, negatively impacted funding for hormone research, and left scientists to unravel the why of the results. Now over a decade and a half since the initial publication of the WHI results, basic and clinical scientists often do not interpret the results of the WHI with the precision needed to move the science forward. This review will 1) describe the historical background leading up to the WHI, 2) list the outcomes from the WHI, and put them in perspective with results of subsequent analysis of the WHI data and results from other prospective menopausal hormone treatment trials addressing cardiovascular effects of menopausal hormone use, and 3) articulate how the collective results are influencing current clinical care with the intent to provide guidance for designing and evaluating relevant new hormonal studies.
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