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La Iniciativa de Salud de la Mujer Ensayos aleatorios y práctica clínica: una revisión

JoAnn E Manson¹, Carolyn J Crandall², Jacques E Rossouw³

¹Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

|May 1, 2024

Resumen

La Iniciativa de Salud de la Mujer encontró que la terapia hormonal es ineficaz para la prevención de enfermedades crónicas, pero es beneficiosa para los síntomas de la menopausia. El calcio más la vitamina D y las dietas bajas en grasas no fueron apoyadas para la prevención rutinaria de fracturas o cáncer.

Área de la Ciencia:

Salud de las mujeres
Ensayos clínicos
Salud pública

Sus antecedentes:

Millones de mujeres posmenopáusicas de todo el mundo se enfrentan a consideraciones de salud.
La Iniciativa de Salud de la Mujer (WHI) es un estudio importante que investiga las intervenciones de salud para las mujeres posmenopáusicas.
Comprender los efectos a largo plazo de las intervenciones es crucial para la práctica clínica.

Objetivo del estudio:

Evaluar los efectos en la salud de la terapia hormonal menopáusica (HT).
Para evaluar el impacto de la suplementación de calcio y vitamina D.
Para determinar la eficacia de una dieta baja en grasas en la prevención de enfermedades crónicas.

Principales métodos:

Se inscribieron 161.808 mujeres posmenopáusicas de entre 50 y 79 años.
Ensayos clínicos aleatorizados realizados entre 1993 y 1998.
Se siguió a los participantes durante hasta 20 años.

Principales resultados:

HT no apoya la prevención de enfermedades cardiovasculares o demencia.
La HT es eficaz para controlar los síntomas de la menopausia de moderados a severos, especialmente en la menopausia temprana.
La suplementación de calcio y vitamina D no se recomienda rutinariamente para la prevención de fracturas.
Una dieta baja en grasas no evitó el cáncer de mama o colorrectal, pero puede reducir la mortalidad por cáncer de mama.

Conclusiones:

La terapia hormonal menopáusica no se recomienda para la prevención de enfermedades crónicas, pero es eficaz para el tratamiento de los síntomas en la menopausia temprana.
La suplementación rutinaria de calcio y vitamina D no es recomendable para todas las mujeres posmenopáusicas.
El papel de una dieta baja en grasas en la reducción de la mortalidad por cáncer de mama requiere más investigación.

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