Comments by owner of this website in green.
From other good readers:
My reading of the paper is that p=0.09 for the vit E/C group, but less than 0.05 for HRT. Therefore, their was no statistical significance in the E/C group.
FYI: Negative science publicized in JAMA
20.11.2002:
NEITHER HRT NOR ANTIOXIDANT VITAMINS PROVIDE CARDIOVASCULAR BENEFIT
IN POSTMENOPAUSAL WOMEN WITH CORONARY DISEASE
CHICAGO - Postmenopausal women with coronary disease do
not receive
cardiovascular benefits from taking hormone replacement therapy
(HRT) or
antioxidant vitamins. In fact, the study suggested that
both treatments
could cause harm.
OF COURSE HRT causes harm (See: What Doctors Don't Tell you NO 10, 2002 - at least the Dutch version)
HRT and antioxidant vitamins are often used for secondary
prevention in
postmenopausal women with coronary disease, but no clinical trials
have
demonstrated benefit to support their use, according to background
information in the article.
David D. Waters, M.D., of San Francisco General Hospital,
and colleagues
conducted a study to determine whether HRT or antioxidant vitamin
supplements, alone or in combination, influence the progression
of coronary
artery disease in postmenopausal women, as measured by coronary
angiography.
The study consisted of the Women's Angiographic Vitamin
and Estrogen
(WAVE) Trial, a randomized, double-blind trial of 423 postmenopausal
women
with at least one 15 percent to 75 percent coronary stenosis (constriction
or narrowing of an artery) at baseline coronary angiography. The
trial was
conducted from July 1997 to January 2002 in seven clinical centers
in the
United States and Canada.
Patients were randomly assigned to receive either 0.625
mg/d of conjugated
equine estrogen (plus 2.5 mg/d of medroxyprogesterone acetate
for women who
had not had a hysterectomy), or matching placebo, and 400 IU of
vitamin E
twice daily plus 500 mg of vitamin C twice daily, or placebo.
The researchers found that coronary progression, measured
in mean change,
worsened for HRT by 0.047 mm/year and by 0.024 mm/year for HRT
placebo; and
for antioxidant vitamins by 0.044 mm/year and with vitamin placebo
by 0.028
mm/year.
"When patients with intercurrent death or myocardial
infarction [MI] were
included, the primary outcome showed an increased risk for women
in the
active HRT group, and suggested an increased risk in the active
vitamin
group," the authors write. "Fourteen patients
died in the HRT group and 8
in the HRT placebo group, and 16 in the vitamin group and
6 in the vitamin
placebo group. Death, nonfatal MI, or stroke occurred in 26 HRT
patients vs.
15 HRT controls and in 26 vitamin patients and 18 vitamin controls."
"The results of this trial add to the accumulating
evidence that neither
HRT nor antioxidant vitamin supplements improve the clinical course
of
coronary disease in postmenopausal women," the researchers
write. "This
information is important because both of these treatments are
commonly used
in this circumstance, with the expectation of benefit, based on
observational data and theoretical concepts.
"Furthermore, these results strengthen the evidence
that HRT causes
cardiovascular harm during the first year or two of treatment.
The increase
in total and cardiovascular mortality in women taking high doses
of vitamins
C and E was unexpected.
This mortalitiy cannot be caused by vitamin C or E, it must have been caused by things like smoking or something. When you start with 75% coronary stenosis and you use ony 1000 milligrams of vitamin C without Lysine or Proline - there is still a high risk.
While this may represent a chance finding, a trend
toward an increase in mortality was observed in the Heart Protection
Study.
Therefore, we conclude that postmenopausal women with coronary
disease
should be discouraged from using both HRT and high doses of vitamin
C and
E."
What was the study - Were they using it BOTH or were they using HRT on one side and vitamin C&E on the other side. The conclusion of this study has been sponsored and rewritten to a certain conclusion which was already there before the study even started!
JAMA 2002;288:2432-2440