Long-Term Study of Postmenopausal Women Does Not Support Many Preventive Therapies

THURSDAY, May 2, 2024 (HealthDay News) -- The longitudinal Women's Health Initiative trials do not support hormone therapy for cardiovascular disease prevention, calcium and vitamin D supplementation for universal fracture prevention, or a low-fat diet for cancer prevention, according to a review published online May 1 in the Journal of the American Medical Association.

JoAnn E. Manson, M.D., Dr.P.H., from Brigham and Women's Hospital in Boston, and colleagues examined the effects of menopausal hormone therapy, calcium plus vitamin D supplementation, and a low-fat dietary pattern on health among 68,132 postmenopausal U.S. women (aged 50 to 79 years at baseline from 1993 to 1998), who were followed for 20 years as part of the Women's Health Initiative.

The researchers found the results do not support hormone therapy with oral conjugated equine estrogens plus medroxyprogesterone acetate for postmenopausal women or conjugated equine estrogens alone for those with prior hysterectomy to prevent cardiovascular disease, dementia, or other chronic diseases, although hormone therapy is effective for treating moderate to severe vasomotor and other menopausal symptoms before age 60 years. Furthermore, the trial results do not support universally recommending calcium plus vitamin D supplementation for fracture prevention, although supplementation is appropriate for women who do not meet national guidelines for recommended intakes of these nutrients through diet. While a low-fat dietary pattern (with increased fruit, vegetable, and grain consumption) does not prevent breast or colorectal cancer, it was associated with lower rates of breast cancer mortality during long-term follow-up.

"Individualized patient care and shared decision-making should be implemented, taking into account patient preferences, severity of symptoms, and cardiometabolic and general health status," the authors write.

One author disclosed ties to the pharmaceutical industry.

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