The diagram is shown in Figure 3 on page 1144.
Hormone replacement therapy:
(1) women with an intact uterus receive either combination estrogen and progestin therapy (estrogen with cyclic progestin for 10-14 days, or estrogen plus continuous progestin)
(2) women without a uterus receive unopposed estrogen (0.625 mg of oral conjugated estrogen or the equivalent once per day)
(3) change in therapy occurs if either breast cancer (all hormones stopped) or endometrial cancer (progestins stopped) develops
Risk factors for coronary heart disease:
(1) smoking cigarettes
(2) diabetes mellitus
(3) left ventricular hypertrophy on electrocardiogram
(4) systolic blood pressure > 174 mm Hg
The sum of risk weights for hip fracture is presented in the previous section.
Women who are considered candidates for hormone replacement therapy:
(1) one or more of the risk factors for coronary heart disease present
(2) AND(no risk factors for coronary heart disease, no first degree relatives with breast cancer, OR(systolic blood pressure > 135 mm Hg, total cholesterol-to-HDL cholesterol ratio > 4.2))
(3) AND(no risk factors for coronary heart disease, no first degree relatives with breast cancer, systolic blood pressure <= 135 mm Hg, total cholesterol-to-HDL cholesterol ratio <= 4.2, sum of risk weights for hip fracture > 1)
(4) AND(no risk factors for coronary heart disease, 1 first degree relative with breast cancer, OR(systolic blood pressure > 150 mm Hg, total cholesterol-to-HDL cholesterol ratio > 5.2))
(5) AND(no risk factors for coronary heart disease, 1 first degree relative with breast cancer, systolic blood pressure <= 150 mm Hg, total cholesterol-to-HDL cholesterol ratio <= 5.2, sum of risk weights for hip fracture > 3)
(6) AND(no risk factors for coronary heart disease, >= 2 first degree relatives with breast cancer, sum of risk weights for hip fracture > 4)
All other women are not considered candidates for hormone replacement therapy.
