Still Looking for a Few Good Women
Do women in the 1990s really have it all? Not in terms of their health. The following statistics reflect the high rates of life-threatening illnesses for post-menopausal women in the US:
- Heart disease is the number one killer of women. It often goes undetected until it is too late for treatment.
- Almost half of women who suffer heart attacks die within one year, as compared to 30 percent of men.
- Approximately 90 percent of heart disease deaths among women occur after menopause.
- One out of eight women will develop breast cancer in her lifetime. The death rate from breast cancer increased 24 percent between 1979 and 1988.
- One out of three women between the ages of 50 and 79 will fracture a hip.
We still have much to learn about the leading causes of illness and death in women. Even though women comprise more than 50 percent of the world population, most major medical studies have focused primarily on men.
Is it possible to decrease the high rates of heart disease, breast and colon cancer, osteoporosis, and Alzheimer's disease in women? The Women's Health Initiative (WHI), a massive, NIH-sponsored clinical study of 167,000 women ages 50 to 79, is attempting to answer this question. UMDNJ, one of the 16 original clinical centers launched in 1993, is participating in the study under the direction of principal investigator Norman L. Lasser, MD, PhD. The study will continue through 2005.
"It's a very interesting group that puts to rest many of the stereotypes about older women," said Lasser. "Many of these women are at or near retirement age Ð yet more than half are still working, even those who are in their sixties and seventies. Others are active in volunteer work and sports."
WHI is divided into several components. In the observational study, the medical history and health habits of 100,000 women are being monitored over the course of several years to examine the relationship between lifestyle, health care and disease. The remaining 67,000 women are part of the randomized controlled clinical trials in one or more of the following categories:
NUTRITION. To evaluate if a lower-fat diet will reduce the risk of heart disease, colon and breast cancer, participants in the intervention group receive intensive dietary counseling by a dietitian 18 times a year for the first year, then quarterly thereafter. The goal is to cut dietary fat to 20 percent or less of total calories and increase consumption of fruits, vegetables, and grains. Women in the intervention group monitor their fat intake through use of a diary or a "fat scan," which estimates grams of fat intake a day. The control group follows their usual diet.CALCIUM/VITAMIN D. To evaluate the effects of the supplements on development of osteoporosis, bone fractures, and colon cancer, participants take two tablets daily: either calcium (1000 mg.) and vitamin D (400 units), or placebos.
HORMONE REPLACEMENT. To evaluate whether hormone replacement therapy decreases the risk of heart disease and osteoporosis, participants receive either Premarin (.625 mg. a day), Premarin plus Provera (2.5 mg a day) or a placebo. Only women who have had a hysterectomy will get estrogen alone.
MEMORY STUDY. Women participating in the hormone replacement trial may be able to join this separate study to evaluate whether estrogen supplementation prevents or delays memory loss due to Alzheimer's disease.
The Women's Health Initiative is again inviting women between the ages of 60 and 79 to become part of this landmark study. Participants must be able to travel to one of three study sites: (Newark, New Brunswick or Paramus) for the initial evaluation and regular follow-up. Because they will be followed over the course of several years, they should not be planning to relocate. To participate, call 800-996-3610 or 973-972-4001. Recruitment for the study will end January 31, 1998.