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Clomid estrogen pills (Coumadin) increased the risk of myocardial infarction, stroke, and death (11). Because no evidence existed to indicate that estrogens, especially those used to treat postmenopausal cancer, affected the risk of ischemic heart disease, large randomized trials to investigate this issue were not completed. Estrogens are thought to decrease the risk of ischemic heart disease by decreasing blood pressure, improving insulin sensitivity, increasing HDL cholesterol, and reducing low-density lipoprotein (LDL) cholesterol (12). However, no long-term outcome studies, like the National Heart, Lung, and Blood Institute's Women's Health Initiative, have shown estrogens to be effective in reducing the risk of ischemic heart disease (13). However, some studies have suggested that nonsteroidal anti-inflammatory medications, which are used to treat pain and reduce inflammation, might delay the progression of coronary artery disease, although this could be from a secondary role for corticosteroids, rather than estrogens or estrogen-like compounds (14). The current study was conducted to clarify the effect of most commonly used oral contraceptive (the progestin-only pill) on risk for cardiac death in women the USA who were not taking hormonal contraception. Methods Patients The Women's Health Initiative was a prospective, randomized, double-blind clinical trial begun in 1995 to determine the effects of two short-acting hormonal contraceptives, mifepristone and ethinyl estradiol (EE), on cardiovascular events in postmenopausal women. The patients were randomly Buy nolvadex and clomid online uk assigned to receive mifepristone (36 or 36 μg/d) and EE (120 μg) or placebo for one year, to receive either placebo (n = 804) or a combination of EE/mifepristone (n = 804). The principal investigators (K.K.D. and M.P.L.), who are responsible for data management, analysis, and writing, were blinded to patient treatment assignment. The project was evaluated by institutional review boards at Brigham and Women's Hospital (Boston) (Providence), by the Food and Drug Administration Safety Surveillance Center. A total of 1469 postmenopausal women were enrolled in the trial. age range was 56–74 y. The initial primary outcome was death from cardiovascular causes. All women with heart disease were followed during the entire trial via mail-return questionnaires. The diagnosis or prognosis of every patient was obtained at screening, baseline, or three annual visits. The most specific and complete information was collected on death from any cause during the trial. Deaths from cardiovascular causes were assigned to an internal review board. Eligible patients with incident cardiovascular disease during the study were offered a randomization to receive either placebo or a combination of EE/mifepristone. After the study was completed, trial investigators reviewed all.
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