HRT - "The 2002 Results"

In the table, we will look at all the results for the relative risk, compared side by side. An additional column (last, in brown), presents results from a meta-study by Dr. Nelson and co-workers, published in JAMA vol 288, p872, 2002. (A meta-study combines results from all existing studies that are considered reliable, to improve the statistical accuracy of the information. Therefore, one expects its conclusions to be more reliable than those of the individual studies).

	Relative Risk (Margin of Error in the parenthesis)
Clinical Event	NHS (Estr + Prog)	HERS (Estr + Prog)	WHI (Estr + Prog)	WHI Estrogen Alone	2002 Meta-study (Nelson)
CHD events	0.39 (0.19-0.78)	0.99 (0.80-1.22)	1.29 (1.02-1.63)	0.91 (0.75-1.12)	0.91 (0.67 - 1.33)
Stroke	1.09 (0.66-1.80)	1.23 (0.89-1.70)	1.41 (1.07-1.85)	1.39 (1.10-1.77)	1.12 (1.01-1.23)
Pulmonary embolism		2.79 (0.89-8.75)	2.13 (1.39-3.25)	1.34 (0.87-2.06)	2.14 (1.64-2.81)
Breast cancer		1.30 (0.77-2.19)	1.26 (1.00-1.59)	0.77 (0.59-1.01)	1.23 - 1.35
Colon cancer		0.69 (0.32-1.49)	0.63 (0.43-0.92)	1.08 (0.75-1.55)	0.80 (0.74-0.86)
Hip fracture		1.10 (0.49-2.50)	0.66 (0.45-0.98)	0.61 (0.41-0.91)	0.76 (0.56-1.01)
Dementia					0.66 (0.53-0.82)
Death		1.08 (0.84-1.38)	0.98 (0.82-1.18)	1.04 (0.88-1.22)
Global index			1.15 (1.03-1.28)	1.01 (0.91-1.12)
The concept of "Global Index" was defined in the WHI studies as representing the first event in the various illnesses.

How can we make sense of this "sea" of numbers? Ignoring (for now) the numbers in parenthesis, the right-hand column, shows how the risk increases (greater that 1.00) or decreases (less than 1.00) when taking HRT, for different diseases. For stroke (1.12), pulmonary embolism (2.14) and breast cancer (1.23 or higher), the risk for these diseases is increased when one takes HRT. The opposite is true for CHD (0.91 implies a small - 9% - reduction in risk), colon cancer (0.80, or 20% less risk), hip fracture (0.76), and dementia (0.66 - later determined to be incorrect!).

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