Heart and Estrogen/progestin Replacement Study (HERS): design, methods, and baseline characteristics

Area of Science:

• Cardiology
• Endocrinology
• Women's Health

Background:

• Postmenopausal hormone therapy is widely used, but its efficacy and safety for preventing recurrent coronary heart disease (CHD) events in women are not well established.
• The Heart and Estrogen/progestin Replacement Study (HERS) was initiated to address this critical knowledge gap.

Purpose of the Study:

• To determine the efficacy and safety of estrogen plus progestin therapy in preventing recurrent coronary heart disease (CHD) events in postmenopausal women with established CHD.
• To evaluate the impact of hormone therapy on other major CHD endpoints, including revascularization and hospitalization for unstable angina.

Main Methods:

• A randomized, double-blind, placebo-controlled trial involving 2763 postmenopausal women with CHD.
• Participants received either conjugated estrogens plus medroxyprogesterone acetate or a placebo daily.
• Follow-up averaged 4.2 years, with CHD events meticulously recorded and analyzed.

Main Results:

• Estrogen plus progestin therapy did not significantly reduce the rate of recurrent coronary heart disease (CHD) events (CHD death and nonfatal myocardial infarction) compared to placebo.
• The study found no significant benefit of hormone therapy in preventing major CHD endpoints in this population.

Conclusions:

• Estrogen plus progestin therapy is not effective in preventing recurrent coronary heart disease (CHD) events in postmenopausal women with existing heart disease.
• These findings have significant implications for the use of hormone therapy in women with cardiovascular disease.