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Is there a window of opportunity?

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Presentation title: Is there a window of opportunity?
Author(s): Mikkola T.
Date: 12 May 2006
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Is there a window of opportunity?
Postmenopausal Hormone Therapy (HT)
HT and cardiovascular disease

Observational Studies of CVD Risk: ET Compared With HT
The Nurses’ Health Study


Absolute risk or benefit of HT in WHI (CEE+MPA arm and CEE-only arm)
What Do Recent Randomized Studies Have in Common?


How to explain the controversial results in observational studies vs. randomized trials
Observational studies subject to

Summary of Differences Between Observational and Clinical Trial Participants
At Vascular Level Timing of HT is Crucial
Estrogen effects in healthy vessel wall

Estrogen effects on atherosclerotic plaque
Effect of ET on Coronary Atherosclerosis: Timing of Initiation
Estrogen Inhibits Initiation but not Progression of Established Lesions in Mice

Effect of HT on CHD in Postmenopausal Women: Timing of Initiation WHI (CEE+MPA-arm)
Effect of HT on CHD in Postmenopausal Women: Timing of Initiation WHI (CEE only-arm)
The Nurses’ Health Study: Timing of Initiation


HT in the future
Further research in demand

Further research in demand
Window of Therapeutic Opportunity
 
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