Main morbidities recorded in the women's international study of long duration oestrogen after menopause (WISDOM): a randomised controlled trial of hormone replacement therapy in postmenopausal women

Vickers, Martin; MacLennan, Alastair H.; Lawton, Beverley; Ford, Deborah; Martin, Jeannett; Meredith, Sarah; DeStavola, Bianca; Rose, Sally B.; Dowell, Anthony; Wilkes, H; Darbyshire, Janet; Meade, T W

doi:10.1136/bmj.39266.425069.ad

Cited by 197 publications

(136 citation statements)

References 40 publications

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“…46 Nevertheless, women in the ␤-Blocker Evaluation of Survival Trial (BEST) who took hormone replacement therapy (estrogen, progestin, or both) show benefits in the rate of death from CHF. 47 The role of estrogen as a cardioprotective agent has been challenged by the findings of the Women's Health Initiative (WHI) study as mentioned previously 7 and by a more recent study by Vickers et al 8 Still, not all agree with the interpretations of the WHI because of the length of time after menopause that hormone replacement therapy was initiated. In a secondary analysis, women who initiated hormone replacement therapy within 10 years of menopause tended to show a reduced risk for CVD, a trend not seen in women Ͼ10 years after the onset of menopause.…”

Section: Estrogen and Congestive Heart Failurementioning

confidence: 78%

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The Effects of Biological Sex and Diet on the Development of Heart Failure

Konhilas

Leinwand

2007

Circulation

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Section: Estrogen and Congestive Heart Failurementioning

confidence: 78%

“…5,6 Recent human studies on hormone replacement therapy similarly question the cardioprotective role of estrogen. 7,8 Clearly, the role of estrogen in cardiovascular disease (CVD) is complex, and further study is necessary. More significantly, it seems unlikely that the male/female dimorphisms in CVD can be attributed to a single factor such as estrogen.…”

mentioning

confidence: 99%

The Effects of Biological Sex and Diet on the Development of Heart Failure

Konhilas

Leinwand

2007

Circulation

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“…However, the cardioprotective role of estrogen was challenged by the findings of the Women's Health Initiative study (Rossouw et al 2002), as well as a study published in the BMJ (Vickers et al 2007). In these studies, estrogen replacement therapy increased cardiovascular events in postmenopausal women.…”

Section: Introductionmentioning

confidence: 93%

Testosterone enhances estradiol's cardioprotection in ovariectomized rats

Liú

Gao²,

Kang

et al. 2011

Journal of Endocrinology

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After menopause, the development of cardiovascular disease (CVD) is due not only to estrogen decline but also to androgen decline. This study examined the effects of either estradiol (E 2 ) or testosterone replacement alone or E 2 -testosterone combination on isolated myocytes in ovariectomized (Ovx) rats subjected to ischemia/reperfusion (I/R). Furthermore, we determined whether the effects are associated with b 2 -adrenoceptor (b 2 -AR). Five groups of adult female Sprague-Dawley rats were used: Sham operation (Sham) rats, bilateral Ovx rats, Ovx rats with E 2 40 mg/kg per day (OvxCE), Ovx rats with testosterone 150 mg/kg per day (OvxCT), and Ovx rats with E 2 40 mg/kg per dayC testosterone 150 mg/kg per day (OvxCE/T). We determined the lactate dehydrogenase (LDH) release, percentage of rod-shaped cells and apoptosis of ventricular myocytes from rats of all groups subjected to I/R. Then, we determined the above indices and contractile function with or without a selective b 2 -AR antagonist ICI 118 551. We also determined the expression of b 2 -AR. Our data show that either E 2 or testosterone replacement alone or E 2 and testosterone in combination decreased the LDH release, increased the percentage of rod-shaped cells, reduced apoptotic cells (%), and combination treatment appeared to be more effective than either E 2 or testosterone replacement alone. ICI 118 551 abolished the effects of the three. Combination supplementation also enhanced the expression of b 2 -AR. We concluded that in Ovx rats, testosterone enhances E 2 's cardioprotection, while E 2 and testosterone in combination was more effective and the protective effects may be associated with b 2 -AR. The study highlights the potential therapeutic application for CVD in postmenopausal women.

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“…The Postmenopausal Estrogen/Progestin Intervention (PEPI) trial included only postmenopausal women whose symptom severity was not assessed (30). In the clinical trials designed to evaluate risks and benefits of the long-term administration of hormone therapy for primary or secondary prevention of chronic diseases in postmenopausal women, those with more severe symptoms were poorly represented (32)(33)(34). Lastly, the duration of our study was longer than most clinical trials of treatments for hot flashes, which have typically been small and brief.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of estrogen plus progestin on menopausal symptoms in women with systemic lupus erythematosus: A randomized, double‐blind, controlled trial

Cravioto¹,

Durand-Carbajal²,

Jiménez-Santana³

et al. 2011

Arthritis Care & Research

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Objective. To define the effects of continuous sequential estrogen plus progestin therapy on menopausal symptoms in women with systemic lupus erythematosus (SLE).Methods. We performed a randomized, double-blind, 24-month clinical trial involving 106 women with SLE who were in the menopausal transition or early or late postmenopause. Patients received continuous sequential estrogen plus progestin (n ‫؍‬ 52) or placebo (n ‫؍‬ 54). Menopausal symptoms were assessed using the Greene Climacteric Scale at 0, 1, 2, 3, 6, 9, 12, 15, 18, 21, and 24 months. A new factor analysis of the scale reduced 21 items to 5 factors. The primary outcome was improvement of menopausal symptoms throughout the followup period. Results were analyzed by the intent-to-treat principle. Results. At baseline, demographic and disease characteristics were similar in both groups. Fifteen of 21 menopausal symptoms had a prevalence of >50%, with a similar distribution between groups. Vasomotor factor scores decreased over time in both groups (P ‫؍‬ 0.002), but in the estrogen plus progestin group the reduction was more pronounced than in the placebo group (1.5-2.0 versus 0.35-0.8 points on a scale of 0 -6; P ‫؍‬ 0.03). Maximum effects were observed among the most symptomatic women. Psychological, subjective-somatic, and organic-somatic factors scores also improved along time (P < 0.001), but the treatment and placebo arms improved to a similar degree. Thromboses occurred in 3 patients receiving estrogen plus progestin and in 1 patient receiving placebo. Conclusion. Menopausal symptoms are highly prevalent in peri-and postmenopausal lupus patients. Estrogen plus progestin improved vasomotor symptoms at a clinically significant level, but not other menopausal symptoms. Given the thrombotic risks of menopausal hormone therapy, this should be used only in women with significant vasomotor symptoms.

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Main morbidities recorded in the women's international study of long duration oestrogen after menopause (WISDOM): a randomised controlled trial of hormone replacement therapy in postmenopausal women

Cited by 197 publications

References 40 publications

The Effects of Biological Sex and Diet on the Development of Heart Failure

The Effects of Biological Sex and Diet on the Development of Heart Failure

Testosterone enhances estradiol's cardioprotection in ovariectomized rats

Efficacy of estrogen plus progestin on menopausal symptoms in women with systemic lupus erythematosus: A randomized, double‐blind, controlled trial

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