Questions and answers about the WHI Coronary Artery Calcification Study (WHI-CACS)

  1. What is the “bottom-line” message of the WHI-CACS study?
  2. Do the WHI-CACS results mean that hormone therapy guidelines should be changed?

1. What is the “bottom-line” message of the WHI-CACS study?

WHI-CACS suggests that women aged 50-59 who were assigned to take estrogen (CEE) had lower amounts of coronary artery calcium after the trial ended compared to women assigned to placebo. These findings provide some reassurance about heart disease risks in younger women with hysterectomy who are taking estrogen-alone. When taken for an average of 7.4 years, estrogen-alone is not likely to increase heart disease risk in recently menopausal women who are considering hormone therapy for menopausal symptoms.

2. Do the WHI-CACS results mean that hormone therapy guidelines should be changed?

No. Hormone therapy should not be started (or continued) to prevent heart disease or other cardiovascular diseases in either younger or older postmenopausal women. Current guidelines remain—hormone therapy should be limited to the treatment of moderate-to-severe menopausal symptoms, and the lowest effective dose should be used for the shortest duration possible.

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