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(Circulation. 2002;105:e9077.)
© 2002 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

Second Verse of HERS Same as the First— No Clear Benefit or Harm for Cardiovascular Disease

The Heart and Estrogen/Progestin Replacement Study (HERS) began with a simple premise: Despite the widespread use of hormone replacement therapy as a heart disease preventive in postmenopausal women with coronary heart disease, no blinded, placebo-controlled clinical trial had ever proved its value beyond a doubt. To the surprise of many, HERS proved a negative—that the treatment had no cardiovascular benefit in these women.

In this issue of Circulation (Circulation. 2002;105:917–922), Curt D. Furberg, MD, PhD, a professor at Wake Forest University School of Medicine (Winston-Salem, NC), and his colleagues at Wake Forest, the University of California (San Francisco), the Chicago Center for Clinical Research, and Emory University School of Medicine (Atlanta, Ga), analyzed the subgroup data from the 2763 postmenopausal women with coronary heart disease enrolled in HERS and again found no clear effect. They identified 86 post hoc subgroup variables. A few of the groups indicated that there might be a trend one way or the other, but when the results were carefully examined, the authors observed:

"Under the assumption of no effect of hormone treatment and given the 86 subgroup analyses, by chance, 4 comparisons would be expected to have a value of P0.05 in the 1-year analyses, and another 4 would be expected to have a value of P0.05 in the overall analyses. Thus, the fact that we observed 6 nominally significant interactions in the first year and 3 in the overall trial is almost exactly what would have been expected by chance . . . [Full Text of this Article]