We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Effects of Hormone Replacement Therapy and Antioxidant Vitamin Supplements on Coronary Atherosclerosis in Postmenopausal Women: A Randomized Controlled Trial.
- Authors
Waters, David D.; Alderman, Edwin L.; Hsia, Judith; Howard, Barbara V.; Cobb, Frederick R.; Rogers, William J.; Ouyang, Pamela; Thompson, Paul; Tardif, Jean Claude; Higginson, Lyall; Bittner, Vera; Steffes, Michael; Gordon, David J.; Proschan, Michael; Younes, Naji; Verter, Joel I.
- Abstract
Context: Hormone replacement therapy (HRT) and antioxidant vitamins are widely used for secondary prevention in postmenopausal women with coronary disease, but no clinical trials have demonstrated benefit to support their use. Objective: To determine whether HRT or antioxidant vitamin supplements, alone or in combination, influence the progression of coronary artery disease in postmenopausal women, as measured by serial quantitative coronary angiography. Design, Setting, and Patients: The Women's Angiographic Vitamin and Estrogen (WAVE) Trial, a randomized, double-blind trial of 423 postmenopausal women with at least one 15% to 75% coronary stenosis at baseline coronary angiography. The trial was conducted from July 1997 to January 2002 in 7 clinical centers in the United States and Canada. Interventions: Patients were randomly assigned in a 2 × 2 factorial design to receive either 0.625 mg/d of conjugated equine estrogen (plus 2.5 mg/d of medroxyprogesterone acetate for women who had not had a hysterectomy), or matching placebo, and 400 IU of vitamin E twice daily plus 500 mg of vitamin C twice daily, or placebo. Main Outcome Measure: Annualized mean (SD) change in minimum lumen diameter (MLD) from baseline to concluding angiogram of all qualifying coronary lesions averaged for each patient. Patients with intercurrent death or myocardial infarction (MI) were imputed the worst rank of angiographic outcome. Results: The mean (SD) interval between angiograms was 2.8 (0.9) years. Coronary progression, measured in mean (SD) change, worsened with HRT by 0.047 (0.15) mm/y and by 0.024 (0.15) mm/y with HRT placebo (P = .17); and for antioxidant vitamins by 0.044 (0.15) mm/y and with vitamin placebo by 0.028 (0.15) mm/y (P = .32). When patients with intercurrent death or MI were included, the primary outcome showed an increased risk for women in the active HRT group (P = .045), and suggested an increased risk in the active vitamin group (P = .09). Fourteen...
- Subjects
DISEASES in women; HORMONE therapy for menopause; CORONARY disease; HEART diseases; MEDICAL experimentation on humans; CLINICAL medicine; CORONARY artery stenosis; PLACEBOS
- Publication
JAMA: Journal of the American Medical Association, 2002, Vol 288, Issue 19, p2432
- ISSN
0098-7484
- Publication type
Article
- DOI
10.1001/jama.288.19.2432