Time to review all the evidence for hormone replacement therapy

doi:10.1136/bmj.330.7487.345

BMJ 2005;330:345 (12 February), doi:10.1136/bmj.330.7487.345

Commentary

Time to review all the evidence for hormone replacement therapy

Fay Crawford, NHS R&D fellow¹, Peter Langhorne, professor of stroke care²

¹ Tayside Centre for General Practice, MacKenzie Building, Dundee DD2 4BF, ² Academic Department for Geriatric Medicine, Glasgow Royal Infirmary, Glasgow G31 2ER

Correspondence to: F Crawford f.crawford@chs.dundee.ac.uk

The first 150 words of the full text of this article appear below.

The meta-analysis by Bath and Gray provides evidence that hormonereplacement therapy does not confer any protection against strokein postmenopausal women but increases their risk of stroke.¹These observations add to a rapidly expanding literature onthe potential hazards and benefits of the therapy.²

The women's health initiative trial contributes well over halfof the current trial data, and its findings dominate the meta-analysis.The women's health initiative trial sought to assess the risksand benefits of three separate interventions—a low fatdiet, hormone replacement therapy, and calcium supplements—in64 500 women over a 15 year period.³ Two separate types of hormonereplacement therapy were tested, monotherapy (oestrogen alone)and dual therapy (oestrogen plus progesterone), in two separatetrial arms recruiting a total of 27 000 women.

In the dual therapy arm of the trial (n = 16 608) an increasedrisk of stroke became apparent by the second . . . [Full text of this article]

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