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HRT againFrom: Ana (aocana58@yahoo.com)Fri Feb 6 18:56:51 2004
Have you seen this? Ann Intern Med 2004; 140: 184-188 HRT use declines after adverse trial results Study findings published in the Annals of Internal Medicine provide further evidence of declines in the use of hormone replacement therapy (HRT) among postmenopausal women after the release of trial findings highlighting cardiac and other risks with treatment. The study showed that the results from the Heart Estrogen/Progesterone Replacement Study (HERS) temporarily caused a modest decrease in HRT use, while release of the principal findings from the Women's Health Initiative (WHI) resulted in more dramatic reductions in use. Jennifer Haas (Brigham and Women's Hospital, Boston, Massachusetts, USA) and colleagues examined the impact of the trial findings on HRT use by conducting questionnaires among postmenopausal women undergoing mammography. The analysis was based on data from 151,862 mammograms performed on 71,219 women in the San Francisco Mammography registry between 1997 and 2003, all of whom were aged 50 to 74 years, without a personal history of breast cancer. Haas and colleagues report that HRT use in the group was estimated at 41% in 1997. Before publication of HERS, use was increasing at a rate of 1% per quarter, but after publication, use decreased by 1% for the same period. When the WHI findings were released in 2002, more dramatic declines were seen, with HRT use dropping by 18% per quarter. These declines were seen in most subgroups of women, including the over 65s, those with previous hysterectomy, and women who described their race or ethnicity as White, Africa-American, Latina, Chinese, or Filipina. "The results from HERS may have had a modest association with use of hormone therapy because this trial included only women with documented coronary heart disease," the researchers suggest. In contrast they note: "The findings from the WHI were widely publicized, and apply to healthy postmenopausal women." The team adds that HERS was conducted for the full study period, whereas the WHI was stopped prematurely by the data safety monitoring board. Haas et al also observe: "The WHI investigators were more decisive in concluding that 'this regimen should not be initiated or continued for the primary prevention of coronary heart disease.'" In an editorial accompanying the study, Lisa Schwartz and Steven Woloshin (VA Outcomes Group, White River Junction, Vermont) suggest that media coverage of the WHI findings may have played an important role in changing HRT use. "The WHI received enormous media coverage - more than 400 newspaper stories and 2500 television-radio stories appeared in the month after release of the findings," they write. "Although some women and their physicians may have responded directly to the WHI results, we think the rapid decline in HRT use points to the influence of the media." Regards Ana Ocana MD Mexico Yahoo! Finance: Get your refund fast by filing online
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