The Women’s Health Initiative Randomized Trials and Clinical Practice

作者：JoAnn E. Manson, Carolyn J. Crandall, Jacques E. Rossouw, Rowan T. Chlebowski, Garnet L. Anderson, Marcia L. Stefanick, Aaron K. Aragaki, Jane A. Cauley, Gretchen Wells, Andrea Z. LaCroix, Cynthia A. Thomson, Marian L. Neuhouser, Linda Van Horn, Charles L Kooperberg, Barbara V. Howard, Lesley Fels Tinker, Jean Wactawski‐Wende, Sally Ann Shumaker, Ross L. Prentice · 发表于：JAMA · 年份：2024 · DOI：10.1001/jama.2024.6542 · 被引用次数：162 · 研究领域：Menopause: Health Impacts and Treatments、Endometriosis Research and Treatment、Sex and Gender in Healthcare

Importance: 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 161 808 postmenopausal US women (N = 68 132 in the clinical trials) aged 50 to 79 years at baseline from 1993 to 1998, and followed them up for up to 20 years. Observations: 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 nut...