The Resource Menopausal hormone therapy for the primary prevention of chronic conditions : systematic review to update the 2002 and 2005 U.S. Preventive Services Task Force recommendations, investigators, Heidi D Nelson ... [et al.], (electronic resource)

Menopausal hormone therapy for the primary prevention of chronic conditions : systematic review to update the 2002 and 2005 U.S. Preventive Services Task Force recommendations, investigators, Heidi D Nelson ... [et al.], (electronic resource)

Label
Menopausal hormone therapy for the primary prevention of chronic conditions : systematic review to update the 2002 and 2005 U.S. Preventive Services Task Force recommendations
Title
Menopausal hormone therapy for the primary prevention of chronic conditions
Title remainder
systematic review to update the 2002 and 2005 U.S. Preventive Services Task Force recommendations
Statement of responsibility
investigators, Heidi D Nelson ... [et al.]
Contributor
Subject
Genre
Language
  • eng
  • eng
Summary
BACKGROUND: Menopausal hormone therapy to prevent chronic conditions, such as cardiovascular disease and cancer, is currently not recommended because of its adverse effects. PURPOSE: To update evidence on the effectiveness of hormone therapy in reducing risks for chronic conditions, its adverse effects, and differences among population subgroups for the U.S. Preventive Services Task Force. DATA SOURCES: We searched MEDLINE (January 2002 to November 30, 2011), Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through third quarter 2011), Scopus, and reference lists. STUDY SELECTION: We included English-language, randomized, placebo-controlled trials that evaluated the prevention of new conditions rather than treatment of existing conditions and reported health outcomes. DATA EXTRACTION: We abstracted details about participants, study design, analysis, followup, and results; study quality was rated using established criteria. DATA SYNTHESIS: Nine fair-quality trials provided data for outcomes. The Women's Health Initiative (WHI) reported most of the results, had 11 years of followup, and was most applicable to the target population. Participants in the WHI estrogen only trial had more risk factors for cardiovascular disease and fewer for breast cancer than those in the estrogen plus progestin trial. In WHI, compared with placebo, estrogen plus progestin reduced fractures (46/10,000 women-years) and increased invasive breast cancer (8/10,000), stroke (9/10,000), deep vein thrombosis (12/10,000), pulmonary embolus (9/10,000), lung cancer death (5/10,000), gallbladder disease (20/10,000), dementia (22/10,000), and urinary incontinence (872/10,000). Estrogen only reduced fractures (56/10,000) and invasive breast cancer incidence (8/10,000) and death (2/10,000), and increased stroke (11/10,000), deep vein thrombosis (7/10,000), gallbladder disease (33/10,000), and urinary incontinence (1271/10,000). Among subgroup analyses, there were no consistent differences by age and comorbidities. LIMITATIONS: Few trials or subgroup analyses were powered for prevention outcomes; 40 to 50 percent of WHI participants discontinued their medications by the end of the trial. CONCLUSIONS: Both hormone therapy regimens decreased fractures but increased stroke, thromboembolic events, gallbladder disease, and urinary incontinence. Estrogen plus progestin increased breast cancer and probable dementia, while estrogen alone decreased breast cancer
Member of
Additional physical form
Issued also in print.
Cataloging source
DNLM
Funding information
Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850; www.ahrq.gov Contract No. HHSA-290-2007-10057-I-EPC3, Task Order No. 3, Prepared by: Oregon Evidence-based Practice Center, Oregon Health & Science University, 3181 SW Sam Jackson Parkway, Portland, OR 97239; www.ohsu.edu/epc
Government publication
federal national government publication
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • bibliography
NLM call number
WP 522
http://library.link/vocab/relatedWorkOrContributorName
  • Nelson, Heidi D
  • United States
  • Oregon Health & Science University
  • U.S. Preventive Services Task Force
Series statement
  • Evidence syntheses
  • AHRQ publication
Series volume
  • no. 93
  • no. 12-05168-EF-1
http://library.link/vocab/subjectName
  • Estrogen Replacement Therapy
  • Menopause
Label
Menopausal hormone therapy for the primary prevention of chronic conditions : systematic review to update the 2002 and 2005 U.S. Preventive Services Task Force recommendations, investigators, Heidi D Nelson ... [et al.], (electronic resource)
Instantiates
Publication
Note
"May 2012."
Bibliography note
Includes bibliographical references
Color
black and white
Dimensions
unknown
Extent
1 online resource (PDF file (98 p.))
Form of item
online
Other physical details
ill.
Specific material designation
remote
System control number
  • 1587609
  • (DNLM)BKSHLF:NBK97827
Label
Menopausal hormone therapy for the primary prevention of chronic conditions : systematic review to update the 2002 and 2005 U.S. Preventive Services Task Force recommendations, investigators, Heidi D Nelson ... [et al.], (electronic resource)
Publication
Note
"May 2012."
Bibliography note
Includes bibliographical references
Color
black and white
Dimensions
unknown
Extent
1 online resource (PDF file (98 p.))
Form of item
online
Other physical details
ill.
Specific material designation
remote
System control number
  • 1587609
  • (DNLM)BKSHLF:NBK97827

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