Women's Health Initiative findings create confusion

Drawing any clear conclusions from the long-awaited trial results is not an easy task.

By Susan J. Landers, AMNews staff. March 13, 2006.

Washington -- Despite recent headlines trumpeting surprising findings from the Women's Health Initiative, the messages for postmenopausal women haven't changed, according to National Institutes of Health officials who ran the large study.

Physicians' advice should continue to be: Don't use hormone therapy to prevent heart disease; don't smoke; aim for a healthy weight; get moving; choose a diet low in saturated fat, trans fat and cholesterol; and keep a close eye on blood pressure, cholesterol and blood glucose levels.

This news should provide some comfort for physicians and patients who may have been buffeted by the recent interpretations of WHI findings.

Some of the results were unexpected and almost shocking. Low-fat diets apparently didn't provide the protection from heart disease and cancer that was promised in earlier studies, calcium and vitamin D didn't prevent as many fractures as was expected, and perhaps the use of estrogen alone was OK for some younger women.

Those results emerged from three randomized trials that were major components of the multimillion-dollar WHI. The trials began in 1991 to address cardiovascular disease, cancer and osteoporosis among postmenopausal women and included 161,000 women ages 50 to 79.

Despite its size, the WHI didn't find all the answers, and its findings were chock full of caveats.

"The data from my paper are not that clear-cut," said one investigator, Judith Hsia, MD, director of the lipid research center at George Washington University in Washington, D.C. She was the lead author of a study on conjugated equine estrogens and coronary heart disease that was published in the Feb. 13 Archives of Internal Medicine.