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Slide Source: Lipids Online Slide Library www.lipidsonline.org Heart and Estrogen/progestin Replacement Study (HERS) and HERS II: Secondary Prevention.

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Presentation on theme: "Slide Source: Lipids Online Slide Library www.lipidsonline.org Heart and Estrogen/progestin Replacement Study (HERS) and HERS II: Secondary Prevention."— Presentation transcript:

1 Slide Source: Lipids Online Slide Library www.lipidsonline.org Heart and Estrogen/progestin Replacement Study (HERS) and HERS II: Secondary Prevention of CHD in Women Randomized trial of 0.625 mg/d conjugated equine estrogens + 2.5 mg/d medroxyprogesterone acetate vs placebo in women with CHD Randomized trial of 0.625 mg/d conjugated equine estrogens + 2.5 mg/d medroxyprogesterone acetate vs placebo in women with CHD Primary endpoint: nonfatal MI or CHD death Primary endpoint: nonfatal MI or CHD death Secondary endpoints: CABG, PTCA, unstable angina, CHF, PVD, TIA Secondary endpoints: CABG, PTCA, unstable angina, CHF, PVD, TIA HERS: 2763 women (average age 67 years) followed up for 4 years HERS: 2763 women (average age 67 years) followed up for 4 years HERS II: 2321 women enrolled in HERS followed up for 6.8 years HERS II: 2321 women enrolled in HERS followed up for 6.8 years Hulley S et al. JAMA 1998;280:605–613. | Grady D et al. JAMA 2002;288:49–57.

2 Slide Source: Lipids Online Slide Library www.lipidsonline.org Kaplan–Meier Estimate of Cumulative Incidence of CHD Events: HERS and HERS II Incidence, % Follow-up, years Grady D et al. JAMA 2002;288:49-57. Copyright ©2002, American Medical Association. 01234567 1380 1383 1303 1334 1247 1269 1196 1209 1133 1122 1043 1039 984 976 354 336 Hormones Placebo No. at risk Hormones Placebo

3 Slide Source: Lipids Online Slide Library www.lipidsonline.org Relative Hazards for Primary CHD Events: HERS and HERS II Relative Hazard (95% Confidence Interval) UnadjustedAdjusted* As Treated† HERS 0.99 (0.81–1.22) 0.96 (0.78–1.18) 1.00 (0.78–1.27) HERS II 1.00 (0.77–1.29) 0.98 (0.75–1.22) 0.82 (0.52–1.32) Overall 0.99 (0.84–1.17) 0.97 (0.82–1.14) 0.96 (0.77–1.19) Period, y 1 1.52 (1.01–2.29) 1.51 (1.00–2.27) 1.52 (0.99–2.33) 2 0.98 (0.66–1.46) 0.94 (0.63–1.41) 1.00 (0.65–1.56) 3 0.85 (0.54–1.33) 0.80 (0.51–1.26) 0.57 (0.30–1.09) 4 0.60 (0.36–0.98) 0.56 (0.34–0.92) 0.58 (0.30–1.12) 5 1.09 (0.71–1.66) 1.06 (0.69–1.62) 1.32 (0.69–2.52) 6–86–86–86–8 0.99 (0.73–1.35) 0.98 (0.72–1.34) 0.71 (0.41–1.26) Grady D et al. JAMA 2002;288:49-57. *Adjusted for age, ethnicity, smoking, BMI, diabetes, SBP, creatinine clearance, exercise, general health, Hx CHF and MI, baseline use of aspirin, ACE inhibitors, and statins, and statin use during follow-up. †Estimates are adjusted for the above variables and restricted to adherent women.


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