Slide Source: Lipids Online Slide Library Women’s Health Initiative: Trial of Estrogen plus Progestin 16,608 women randomized 16,608 women randomized Conjugated equine estrogens mg/d + medroxyprogesterone acetate 2.5 mg/d vs. placebo Conjugated equine estrogens mg/d + medroxyprogesterone acetate 2.5 mg/d vs. placebo Primary outcome: nonfatal MI or CHD death Primary outcome: nonfatal MI or CHD death Primary adverse outcome: breast cancer Primary adverse outcome: breast cancer Stopped early (mean follow-up 5.2 years) because health risks exceeded benefits Stopped early (mean follow-up 5.2 years) because health risks exceeded benefits Writing Group for the WHI Investigators. JAMA 2002;288:

Slide Source: Lipids Online Slide Library *1st event: CHD; stroke; pulmonary embolism; breast, endometrial, or colorectal cancer; hip fracture, or death due to other causes Risks and Benefits of Estrogen/Progestin on Clinical Outcomes: Women’s Health Initiative Outcome Hazard Ratio Nominal 95% CI Adjusted 95% CI CHD (MI, coronary death) – –1.97 CABG/PTCA – –1.51 Stroke – –2.31 Venous thromboembolic disease – –3.55 Total CVD – –1.49 Cancer – –1.22 Fractures – –0.92 Death – –1.37 Global index* – – 1.39 Writing Group for the WHI Investigators. JAMA 2002;288:

Slide Source: Lipids Online Slide Library Absolute Excess Risks and Absolute Risk Reductions per 10,000 Person-Years: Women’s Health Initiative Difference in risk per 10,000 person-years CHD events+7 Strokes+8 Pulmonary embolisms+8 Invasive breast cancer+8 Colorectal cancers–6 Hip fractures–5–5 Global index+19 Writing Group for the WHI Investigators. JAMA 2002;288: