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Trials on hormone therapy and hypertension treatment change practice, medication usage of patients

Recent results from clinical trials on hormone therapy and treating hypertension have changed the way physicians prescribe and the way patients use certain medications, according to two studies in the January 7 issue of The Journal of the American Medical Association (JAMA).

In the first article, Adam L. Hersh, M.D., Ph.D., of the Stanford University School of Medicine, Stanford, Calif., and colleagues examined the national trends in hormone therapy use and prescriptions since 1995 to determine the impact of recent evidence on hormone therapy.

According to background information in the article, postmenopausal hormone therapy use increased dramatically over the past 2 decades because of a prevailing belief in its health benefits. But recent evidence from randomized trials published in July 2002 (the Heart and Estrogen/Progestin Replacement Study follow-up [HERS II]; the Women's Health Initiative [WHI]) either demonstrated no benefit or indicated adverse cardiovascular disease events and other risks with hormone therapy in the form of oral estrogen combined with progestin.

The researchers used two databases to determine national trends in hormone therapy use from January 1995 to July 2003: the National Prescription Audit database provided data on the number of hormone therapy prescriptions filled by retail pharmacies; and the National Disease and Therapeutic Index database provided data on patient visits to office-based physicians during which hormone therapy was prescribed.

The researchers found that annual hormone therapy prescriptions increased from 58 million in 1995 to 90 million in 1999, representing approximately 15 million women per year, then remained stable through June 2002. Adoption of new oral estrogen/progestin combinations, primarily Prempro, accounted for most of this growth.

"Following the publication of [WHI] trial results in July 2002, hormone therapy prescriptions declined in successive month
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Contact: Randall S. Stafford
650-724-2400
JAMA and Archives Journals
6-Jan-2004


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