Womens Health initiative

Womens Health initiative - Women’s Health And The...

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Unformatted text preview: Women’s Health And The Women’s Health And The Women’s Health Initiative Study Lisa Killinger, DC The Women's Health Initiative The (WHI) is a major 15­year research program to address the most common causes of death, disability and poor quality of life in postmenopausal women ­­ Primary topics studied: Primary topics studied: • cardiovascular disease • cancer • osteoporosis More on the WHI More on the WHI • • • • • Launched in 1991 A set of clinical trials One observational study Involve more than 161,000 women Mostly healthy & postmenopausal Randomized Clinical Trial (RCT) Randomized Clinical Trial (RCT) • Hormone Replacement Therapy Trial (HRT) • Dietary Modification Trial (DM) • Calcium/Vitamin D Supplementation Trial (CaD) Observational Study (OS) Observational Study (OS) • OS Participants: – From 40 Clinical Centers (CC) nationwide – 167,000 women aged 50­79; 67,000 in RCT 100,000 in OS – 20% overall minority recruitment: 10 CC's with goal of 60% Community Prevention Study Community Prevention Study (CPS) • CPS Participants: – at CDC funded University­based Prevention Research Centers CPS Study Topics CPS Study Topics • Reducing CVD Risk Among Black Women • • • • (Johns Hopkins) CVD Peer Support in Afr­American Women (U Alabama) Environmental Factors & Physical Activity in Women (SLU) Osteoporosis Prevention (UNC; Chapel Hill) Diabetes Care in Minority Women (UNC) WHI­ HRT study WHI­ HRT study The “pill” and its effect on women • • • • • Heart Disease Breast Cancer Osteoporosis Stroke Dementia Estrogen + Progestin vs. Placebo Estrogen + Progestin vs. Placebo The rate per 10,000 women per year Breast Cancer Heart Attack Stroke Blood Clots Hip Fracture Colorectal Cancer Placebo Pills Estrogen Plus Progestin Pills 30 30 38 37 15 16 10 10 21 16 29 34 Summary of Results: Heart Summary of Results: Heart • Women on Estrogen/Progest Pill not protected from heart disease • E & P: 24% Increase in heart disease risk • Highest risk increase in women w/ hi LDL Manson, et al. NEJM Aug 7, 2003. Vol. 349(6):523­534. Summary of Results: Summary of Results: Breast Cancer • E & P Group: 24% increase in Breast Cancer risk Chebowski, et al. JAMA 2002 June 225. Vol. 289(24): 3243­3254. Results: Dementia Results: Dementia • May, 20, 2003 JAMA • E&P Group: Twice the risk of dementia (Alzheimer’s) • Resource Orgs: – www.alzheimers.org – ADEAR: 1­800­438­4380 Other Results… Other Results… • E&P and Stroke: Risk increased 31% • E &P and Blood Clots: Risk increased 61% • Osteoporosis and Colorectal Cancer: E&P may protect, but risks outweigh the benefits • E&P part of study was cancelled due to increased rates of disease! Resources on Women’s Health Resources on Women’s Health • • • • www.4women.org Nat’l Women’s Health Info Center 1­800­994­Woman www.nhlbi.nih.gov/whi (women’s health init) • National Domestic Abuse Hotline: 1­800­ 799­SAFE (violence is a leading cause of injury in women ages 15­54) ...
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