Trial reportJAMA2004
Estrogen plus progestin and risk of venous thrombosis.
Trial report in JAMA, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 143 papers, 16 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Women's Health Initiative (WHI)
Characterizing the Neural Substrates of Irritability in Women: an Experimental Neuroendocrine Model
Who cites it
143 citing papers in PubMed, 16 syntheses or guidelines pooled it, 627 citations in OpenAlex.
- Sex as a prognostic factor for mortality in adults with acute symptomatic pulmonary embolism.The Cochrane database of systematic reviews · 2025Pooled it
- Brazilian Guideline on Menopausal Cardiovascular Health - 2024.Arquivos brasileiros de cardiologia · 2024Guideline
- Genome-wide investigation of exogenous female hormones, genetic variation, and venous thromboembolism risk.Journal of thrombosis and haemostasis : JTH · 2024Pooled it
- Long-term hormone therapy for perimenopausal and postmenopausal women.The Cochrane database of systematic reviews · 2017Pooled it
- Venous thromboembolism has the same risk factors as atherosclerosis: A PRISMA-compliant systemic review and meta-analysis.Medicine · 2016Pooled it
- Diabetes mellitus and venous thromboembolism: A systematic review and meta-analysis.Diabetes research and clinical practice · 2016Pooled it
- Hormone therapy for preventing cardiovascular disease in post-menopausal women.The Cochrane database of systematic reviews · 2015Pooled it
- Risk of venous thromboembolism associated with single and combined effects of Factor V Leiden, Prothrombin 20210A and Methylenetethraydrofolate reductase C677T: a meta-analysis involving over 11,000 cases and 21,000 controls.European journal of epidemiology · 2013Pooled it
- Hormone replacement therapy for women with type 1 diabetes mellitus.The Cochrane database of systematic reviews · 2013Pooled it
- Current and former smoking and risk for venous thromboembolism: a systematic review and meta-analysis.PLoS medicine · 2013Pooled it
- The 2012 hormone therapy position statement of: The North American Menopause Society.Menopause (New York, N.Y.) · 2012Guideline
- Menopausal symptoms.BMJ clinical evidence · 2011Pooled it
- Menopausal symptoms.BMJ clinical evidence · 2010Pooled it
- Black cohosh for the management of menopausal symptoms : a systematic review of clinical trials.Drugs & aging · 2009Pooled it
- Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2008Pooled it
- Estrogen and progestogen use in postmenopausal women: July 2008 position statement of The North American Menopause Society.Menopause (New York, N.Y.)Guideline
- Influence of Cardiometabolic Status on Cardiovascular Effects of Oral Menopausal Hormone Therapy.Obstetrics and gynecology · 2026Trial
- Tissue Factor Pathway Inhibitor, Activated Protein C Resistance, and Risk of Coronary Heart Disease Due To Combined Estrogen Plus Progestin Therapy.Arteriosclerosis, thrombosis, and vascular biology · 2016Trial
- The effect of calcium plus vitamin D supplementation on the risk of venous thromboembolism. From the Women's Health Initiative Randomized Controlled Trial.Thrombosis and haemostasis · 2015Trial
- Trial
83 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextPostmenopausal hormone therapy increases the risk of venous thrombosis. It is not known whether other factors influencing thrombosis add to this risk.
objectiveTo report final data on incidence of venous thrombosis in the Women's Health Initiative Estrogen Plus Progestin clinical trial and the association of hormone therapy with venous thrombosis in the setting of other thrombosis risk factors. DESIGN, SETTING, AND
participantsDouble-blind randomized controlled trial of 16,608 postmenopausal women between the ages of 50 and 79 years, who were enrolled in 1993 through 1998 at 40 US clinical centers with 5.6 years of follow up; and a nested case-control study. Baseline gene variants related to thrombosis risk were measured in the first 147 women who developed thrombosis and in 513 controls.
interventionRandom assignment to 0.625 mg/d of conjugated equine estrogen plus 2.5 mg/d of medroxyprogesterone acetate, or placebo.
main outcome measuresCentrally validated deep vein thrombosis and pulmonary embolus.
resultsVenous thrombosis occurred in 167 women taking estrogen plus progestin (3.5 per 1000 person-years) and in 76 taking placebo (1.7 per 1000 person-years); hazard ratio (HR), 2.06 (95% confidence interval [CI], 1.57-2.70). Compared with women between the ages of 50 and 59 years who were taking placebo, the risk associated with hormone therapy was higher with age: HR of 4.28 (95% CI, 2.38-7.72) for women aged 60 to 69 years and 7.46 (95% CI, 4.32-14.38) for women aged 70 to 79 years. Compared with women who were of normal weight and taking placebo, the risk associated with taking estrogen plus progestin was increased among overweight and obese women: HR of 3.80 (95% CI, 2.08-6.94) and 5.61 (95% CI, 3.12-10.11), respectively. Factor V Leiden enhanced the hormone-associated risk of thrombosis with a 6.69-fold increased risk compared with women in the placebo group without the mutation (95% CI, 3.09-14.49). Other genetic variants (prothrombin 20210A, methylenetetrahydrofolate reductase C677T, factor XIII Val34Leu, PAI-1 4G/5G, and factor V HR2) did not modify the association of hormone therapy with venous thrombosis.
conclusionsEstrogen plus progestin was associated with doubling the risk of venous thrombosis. Estrogen plus progestin therapy increased the risks associated with age, overweight or obesity, and factor V Leiden.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.