[CRS_META] Fw: [CR] Health after stopping hormone therapy

Mon Mar 10 17:57:18 EDT 2008

What gives?  It is March 10 today.

Cheers, Al

[CR] Health after stopping hormone therapy
Al Pater alpater at shaw.ca
Tue Mar 4 19:46:47 EST 2008

-- Al Pater, alpater at SHAW.ca

From: "Al Pater" <alpater at shaw.ca>
To: <CR at lists.calorierestriction.org>
Sent: Tuesday, March 04, 2008 5:46 PM
Subject: [CR] Health after stopping hormone therapy

> The (02) paper is pdf-availed, all of its (1-11, except 6 and 7) 
> references
> are free full-text, and the (7) paper is additionally pdf-availed. 
> Stopping
> hormone therapy did not seem to benefit health.  All-cause mortality
> matters.  CR may confer a sex hormone-reduced state, and the below papers
> appear to me to indicate one possible basis for CR longevity action.
>
>
> 01.  This Week in JAMA
> JAMA. 2008;299(9):989.
> Health Risks After Stopping Estrogen Plus Progestin
>
> The Women's Health Initiative trial comparing the effects of estrogen plus
> progestin (CEE plus MPA) vs placebo on risks of heart disease, breast
> cancer, and fractures was stopped early after a mean 5.6 years when it was
> found that the therapy was associated with an increased risk of invasive
> breast cancer and no overall health benefit. To assess changes in
> hormone-relevant health conditions when CEE plus MPA is stopped, Heiss and
> colleagues analyzed data from 15 730 trial participants (95%) who agreed 
> to
> postintervention follow-up through the planned study duration of 8.5 
> years.
> The authors report that compared with women who were randomly assigned to
> placebo, women in the CEE plus MPA group had comparable cardiovascular
> disease and fracture risks, a significantly increased risk of 
> malignancies,
> and a higher global risk index during the mean 2.4-year postintervention
> follow-up period.
>
>
> 02.  Health Risks and Benefits 3 Years After Stopping Randomized Treatment
> With Estrogen and Progestin
> Gerardo Heiss; Robert Wallace; Garnet L. Anderson; Aaron Aragaki; Shirley 
> A.
> A. Beresford; Robert Brzyski; Rowan T. Chlebowski; Margery Gass; Andrea
> LaCroix; JoAnn E. Manson; Ross L. Prentice; Jacques Rossouw; Marcia L.
> Stefanick; for the WHI Investigators
> JAMA. 2008;299(9):1036-45.
>
> ABSTRACT
>
> Context  The Women's Health Initiative (WHI) trial of estrogen plus
> progestin vs placebo was stopped early, after a mean 5.6 years of 
> follow-up,
> because the overall health risks of hormone therapy exceeded its benefits.
>
> Objective  To report health outcomes at 3 years (mean 2.4 years of
> follow-up) after the intervention was stopped.
>
> Design, Setting, and Participants  The intervention phase was a
> double-blind, placebo-controlled, randomized trial of conjugated equine
> estrogens (CEE) 0.625 mg daily plus medroxyprogesterone acetate (MPA) 2.5 
> mg
> daily, in 16 608 women aged 50 through 79 years, recruited by 40 centers
> from 1993 to 1998. The postintervention phase commenced July 8, 2002, and
> included 15 730 women.
>
> Main Outcome Measures  Semi-annual monitoring and outcomes ascertainment
> continued per trial protocol. The primary end points were coronary heart
> disease and invasive breast cancer. A global index summarizing the balance
> of risks and benefits included the 2 primary end points plus stroke,
> pulmonary embolism, endometrial cancer, colorectal cancer, hip fracture, 
> and
> death due to other causes.
>
> Results  The risk of cardiovascular events after the intervention was
> comparable by initial randomized assignments, 1.97% (annualized rate) in 
> the
> CEE plus MPA (343 events) and 1.91% in the placebo group (323 events). A
> greater risk of malignancies occurred in the CEE plus MPA than in the
> placebo group (1.56% [n = 281] vs 1.26% [n = 218]; hazard ratio [HR], 
> 1.24;
> 95% confidence interval [CI], 1.04-1.48). More breast cancers were 
> diagnosed
> in women who had been randomly assigned to receive CEE plus MPA vs placebo
> (0.42% [n = 79] vs 0.33% [n = 60]; HR, 1.27; 95% CI, 0.91-1.78) with a
> modest trend toward a lower HR during the follow-up after the 
> intervention.
> All-cause mortality was somewhat higher in the CEE plus MPA than in the
> placebo group (1.20% [n = 233] vs 1.06% [n = 196]; HR, 1.15; 95% CI,
> 0.95-1.39). The global index of risks and benefits was unchanged from
> randomization through March 31, 2005 (HR, 1.12; 95% CI, 1.03-1.21),
> indicating that the risks of CEE plus MPA exceed the benefits for chronic
> disease prevention.
>
> Conclusions  The increased cardiovascular risks in the women assigned to 
> CEE
> plus MPA during the intervention period were not observed after the
> intervention. A greater risk of fatal and nonfatal malignancies occurred
> after the intervention in the CEE plus MPA group and the global risk index
> was 12% higher in women randomly assigned to receive CEE plus MPA compared
> with placebo.
>
> Financial Disclosures: Dr Howard reports that she is a consultant for 
> Merck
> and the Egg Nutrition Council, receives research support from Pfizer, 
> Merck,
> and Schering-Plough, and lectures for Schering-Plough. Dr Chlebowski 
> reports
> that he has received grant funding from Lilly and Organon. Dr Gass reports
> that she has received funding support for multisite clinical trials from
> Procter & Gamble Pharmaceuticals, Roche, and Wyeth Pharmaceuticals, and
> honoraria from Aventis, Eli Lilly & Co, Esprit Pharma, GlaxoSmithKline,
> Novartis, Merck & Co Inc, Procter & Gamble Pharmaceuticals, Roche,
> Upsher-Smith Laboratories Inc, Wyeth Pharmaceuticals Inc. Dr Wallace 
> serves
> on the safety and data monitoring boards for trials sponsored by Merck and
> Novartis.
>
> 1. Rossouw JE, Anderson GL, Prentice RL; et al.
> Risks and benefits of estrogen plus progestin in healthy postmenopausal
> women: principal results from the Women's Health Initiative randomized
> controlled trial.
> JAMA. 2002;288(3):321-333. FREE FULL TEXT
> http://jama.ama-assn.org/cgi/content/full/297/13/1465
>
> 2. Manson JE, Hsia J, Johnson KC; et al.
> Estrogen plus progestin and the risk of coronary heart disease.
> N Engl J Med. 2003;349(6):523-534. FREE FULL TEXT
> http://content.nejm.org/cgi/content/full/349/6/523
>
> 3. Wassertheil-Smoller S, Hendrix SL, Limacher M; et al.
> Effect of estrogen plus progestin on stroke in postmenopausal women: the
> Women's Health Initiative: a randomized trial.
> JAMA. 2003;289(20):2673-2684. FREE FULL TEXT
> http://jama.ama-assn.org/cgi/content/full/289/20/2673
>
> 4. Anderson GL, Judd HL, Kaunitz AM; et al.
> Effects of estrogen plus progestin on gynecologic cancers and associated
> diagnostic procedures the Women's Health Initiative randomized trial.
> JAMA. 2003;290(13):1739-1748. FREE FULL TEXT
> http://jama.ama-assn.org/cgi/content/full/290/13/1739
>
> 5. Chlebowski RT, Hendrix SL, Langer RD; et al.
> Influence of estrogen plus progestin on breast cancer and mammography in
> healthy postmenopausal women: the Women's Health Initiative Randomized
> Trial.
> JAMA. 2003;289(24):3243-3253. FREE FULL TEXT
> http://jama.ama-assn.org/cgi/content/full/288/3/321
>
> 6. Anderson GL, Chlebowski RT, Rossouw JE, Rodabough RJ, McTiernan A,
> Margolis KL, Aggerwal A, David Curb J, Hendrix SL, Allan Hubbell F,
> Khandekar J, Lane DS, Lasser N, Lopez AM, Potter J, Ritenbaugh C.
> Prior hormone therapy and breast cancer risk in the Women's Health
> Initiative randomized trial of estrogen plus progestin.
> Maturitas. 2006 Sep 20;55(2):103-15. Epub 2006 Jul 11.
> PMID: 16815651
> http://www.ncbi.nlm.nih.gov/pubmed/16815651?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
>
> 7. Machens K, Schmidt-Gollwitzer K.
> Estrogen plus progestin and colorectal cancer in postmenopausal women.
> N Engl J Med. 2004 Jun 3;350(23):2417-9; author reply 2417-9. No abstract
> available.
> PMID: 15179698
>
> 8. Cauley JA, Robbins J, Chen Z; et al.
> Effects of estrogen plus progestin on risk of fracture and bone mineral
> density: the Women's Health Initiative randomized trial.
> JAMA. 2003;290(13):1729-1738. FREE FULL TEXT
> http://jama.ama-assn.org/cgi/content/full/290/13/1729
>
> 9. Cushman M, Kuller LH, Prentice R; et al.
> Estrogen plus progestin and risk of venous thrombosis.
> JAMA. 2004;292(13):1573-1580. FREE FULL TEXT
> http://jama.ama-assn.org/cgi/content/full/292/13/1573
>
> 10. LaCroix AZ.
> Estrogen with and without progestin: benefits and risks of short-term use.
> Am J Med. 2005 Dec 19;118 Suppl 12B:79-87.
> PMID: 16414331 FULL TEXT | PUBMED
> http://www.ncbi.nlm.nih.gov/pubmed/16414331?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
> http://www.hc-sc.gc.ca/iyh-vsv/med/estrogen_e.html
>
> 11. Rossouw JE, Prentice RL, Manson JE; et al.
> Postmenopausal hormone therapy and risk of cardiovascular disease by age 
> and
> years since menopause.
> JAMA. 2007;297(13):1465-1477. FREE FULL TEXT
> http://jama.ama-assn.org/cgi/content/full/297/13/1465
>
> -- Al Pater, alpater at SHAW.ca
>
>
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