The women's health initiative: lessons learned.

Publication Type:

Journal Article


Annual review of public health, Volume 29, p.131-50 (2008)


2008, 258, Aged, Breast Neoplasms, Calcium, Dietary, Colorectal Neoplasms, Coronary Disease, Diet, Fat-Restricted, Estrogen Replacement Therapy, Female, Hip Fractures, Humans, Middle Aged, Postmenopause, Primary Prevention, Randomized Controlled Trials as Topic, United States, Vitamin D, Women's Health


The Women's Health Initiative (WHI) was initiated in 1992 as a major disease-prevention research program among postmenopausal women. The program includes a randomized controlled intervention trial involving 68,132 women and four distinct interventions: conjugated equine estrogens, alone or in combination with medroxyprogesterone acetate, for coronary heart disease prevention with breast cancer as an anticipated adverse effect; a low-fat eating pattern for breast and colorectal cancer prevention; and calcium and vitamin D supplementation for hip fracture prevention. Results from this multifaceted trial have made a substantial impact in clinical practice. A companion cohort study among 93,676 women serves as a source for new risk factor information and provides a comparative observational assessment of the clinical trial interventions. A specimen repository and quality-controlled outcome data for a range of diseases are among the resources that support the ongoing research program. WHI clinical trial contributions and challenges are reviewed and discussed.