Hormone replacement therapy (HRT) had gained a positive image due to results from the Nurses Health Study, and other cohort trials, but randomized clinical trials wiped out many of its presumed benefits. In 1998 the results of a large clinical trial challenged a crucial claim that HRT protected the heart. Then a second study, sponsored by National Institutes of Health (NIH), found that HRT not only didn'the risk of heart disease —increased it! The NIH trial covering 16,600 postmenopausal women also found other damaging evidence such as increased risk of stoke and breast cancer. Even some of HRT's heralded advantages such as an improved quality of life were not supported. An explanation on why the nurses cohort study apparently got it wrong is traced to the nurses taking hormones who turned out to be healthier, better educated, from a higher socioeconomic class and with better health care access compared to the nurses not taking hormones. Key differences between the cohort studies and the clinical trials are also examined to see if the differences between them could account for some of the conflicting results as well.
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Chapter 17 — Hormone Replacement Therapy
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(2009). Hormone Replacement Therapy – The Silver Bullet That Misfired. In: It's Great! Oops, No It Isn't. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-8907-7_17
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