Womens Health And The Womens Health Initiative Study

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Womens Health And The Womens Health Initiative
Study

• Lisa Killinger, DC

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The Women's Health Initiative (WHI) is a major
15-year research program to address the most
common causes of death, disability and poor
quality of life in postmenopausal women --
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Primary topics studied

• cardiovascular disease
• cancer
• osteoporosis

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More on the WHI

• Launched in 1991
• A set of clinical trials
• One observational study
• Involve more than 161,000 women
• Mostly healthy postmenopausal

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Randomized Clinical Trial (RCT)

• Hormone Replacement Therapy Trial (HRT)
• Dietary Modification Trial (DM)
• Calcium/Vitamin D Supplementation Trial (CaD)

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Observational Study (OS)

• OS Participants
• From 40 Clinical Centers (CC) nationwide
• 167,000 women aged 50-79 67,000 in RCT 100,000
  in OS
• 20 overall minority recruitment10 CC's with
  goal of 60

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Community Prevention Study (CPS)

• CPS Participants
• at CDC funded University-based Prevention
  Research Centers

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CPS Study Topics

• Reducing CVD Risk Among Black Women (Johns
  Hopkins)
• CVD Peer Support in Afr-American Women (U
  Alabama)
• Environmental Factors Physical Activity in
  Women (SLU)
• Osteoporosis Prevention (UNC Chapel Hill)
• Diabetes Care in Minority Women (UNC)

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WHI- HRT study The pill and its effect on women

• Heart Disease
• Breast Cancer
• Osteoporosis
• Stroke
• Dementia

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Estrogen Progestin vs. Placebo
The rate per 10,000 women per year
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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)523-534.

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Summary of Results Breast Cancer

• E P Group 24 increase in Breast Cancer risk
• Chebowski, et al. JAMA 2002 June 225. Vol.
  289(24) 3243-3254.

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Results Dementia

• May, 20, 2003 JAMA
• EP Group Twice the risk of dementia
  (Alzheimers)
• Resource Orgs
• www.alzheimers.org
• ADEAR 1-800-438-4380

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Other Results

• EP and Stroke Risk increased 31
• E P and Blood Clots Risk increased 61
• Osteoporosis and Colorectal Cancer EP may
  protect, but risks outweigh the benefits
• EP part of study was cancelled due to increased
  rates of disease!

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Resources on Womens Health

• www.4women.org
• Natl Womens Health Info Center
• 1-800-994-Woman
• www.nhlbi.nih.gov/whi (womens health init)
• National Domestic Abuse Hotline [phone]-SAFE
  (violence is a leading cause of injury in women
  ages 15-54)