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Estrogen Plus Progestin Therapy: The Cardiovascular Risks Exceed the Benefits

Penckofer, Sue M. PhD, RN; Hackbarth, Diana PhD, RN, FAAN; Schwertz, Dorie W. PhD, RN, FAAN

The Journal of Cardiovascular Nursing: November-December 2003 - Volume 18 - Issue 5 - p 347–355

The surprising results of the Women's Health Initiative (WHI) reported in 2002 had a profound effect on women as well as health care practitioners. The WHI was the largest, randomized clinical trial designed to determine if postmenopausal hormone use prevented cardiovascular disease as well as other age-related disorders in women. While observational studies suggested that postmenopausal use of estrogen could decrease cardiovascular risk by 40% to 50%, the WHI demonstrated that use of continuous-combined estrogen plus progestin was not cardioprotective and was even associated with increased health risks. The estrogen alone trial of the WHI is still in progress, leaving practitioners and some women still in a dilemma. This article addresses the WHI in the context of other studies and discusses possible reasons for the unexpected results.

Sue M. Penckofer, PhD, RN Professor and Associate Dean for Research, School of Nursing, Loyola University Chicago, Ill.

Diana Hackbarth, PhD, RN, FAAN Professor, Department of Health Promotion, Primary Care, Health Systems and Dietetics, School of Nursing, Loyola University Chicago, Ill.

Dorie W. Schwertz, PhD, RN, FAAN Associate Professor, Department of Medical Surgical Nursing and Pharmacology, College of Nursing, University of Illinois, Chicago, Ill.

Corresponding author Sue M. Penckofer, PhD, RN, School of Nursing, Loyola University Health System, Bld 105, Room 2840, 2160 S First Ave, Maywood, IL 60153 (e-mail:

© 2003 Lippincott Williams & Wilkins, Inc.