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Possible benefits of Hormone Replacement Therapy

omen in WEST received the standard 1 milligram daily dose of oral estrogen in the form of estradiol. The other half got a placebo. Neither the women nor the researchers knew who got which pills. Patients were studied for three years on average. They stopped receiving the estradiol or the placebo if they had a stroke.

Researchers reported that at the end of the study, 120 women in the estradiol group had died or suffered a non-fatal stroke, compared with 100 in the placebo group, a difference that could have been due to chance. However, there was a "borderline" statistically significant higher number of fatal strokes in the estradiol group — 12 vs. four in the placebo group, Viscoli says. And non-fatal strokes were slightly more debilitating in the estradiol group.

The WEST study parallels another study called the Heart and Estrogen Replacement Study, or HERS, the first randomized hormone replacement therapy trial. HERS used Premarin, the most commonly prescribed estrogen in the USA, and enrolled only women with heart disease. It found no difference in the total number of heart attacks, strokes or blood clots between women on HRT and those on placebo.

Manson is a principal investigator in the Women's Health Initiative, a federally funded study in which 20,000 women have been randomly assigned to Premarin or a placebo. Final results are due in 2004, but an interim analysis after four years found no difference between the HRT and placebo groups.


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