Gary H. Gibbons, M.D. - May 11, 2015
The Women’s Health Initiative (WHI), one of the largest women's health projects ever launched in the United States, continues to yield new insights for the health of women. As the program gears up to launch two new trials, I took the opportunity to acknowledge the contributions of women who have participated in the WHI for many years, and sent them a heartfelt note of thanks. They responded with numerous sincere sentiments of gratitude for being able to participate in the study. This made me pause: I was thanking them, but they made a point to be grateful for having played a role in the process. In truth – they didn’t just play a part – the scientific advances that have come from the WHI wouldn’t have been possible without the pioneering women who participated in the trial, shared data about their health and lifestyle, and provided specimens. Their contributions have advanced our understanding about women’s heart disease, and other diseases, and improved the lives of women around the world. They are the true heroines of our research.
The WHI, first awarded in 1992, has become an important national resource for scientific research of the highest quality. It has helped us understand the causes of and how to reduce the risk of heart disease, breast and colorectal cancer, and osteoporosis. To both honor and to help you get to know some of these real life heroines, NHLBI has created a couple of digital scrapbook pages featuring a small sampling of WHI participants. There you’ll meet women who exemplify healthy aging, like Marion Nebel of Mequon, Wisc., now 89, who went skydiving on her 85th birthday; and Rose Blamowski, 85, of Buffalo, N.Y. who exercises at the gym five days a week.
“I joined the Women’s Health Initiative so that I could contribute to the future well-being of my four daughters, four granddaughters, and three great granddaughters,” Rose said.
The WHI was established to study strategies to prevent the most common causes of death, disability, and poor quality of life in postmenopausal women. This long-term project, led by NHLBI, has involved more than 161,000 women. The study demonstrated that use of estrogen/progestin postmenopausal hormone therapy not only failed to protect women from coronary heart disease but also increased their risk of developing invasive breast cancer. The WHI also showed that this therapy increased the risk of stroke, memory problems and dementia, urinary incontinence, and gallbladder disease while it decreased the risk of fractures and diabetes.
The study and its findings have changed the face of women’s health and medical practice around the world by helping women and their health care providers make more informed decisions, particularly about the use of hormone therapy. As a result of this trial, prescribing of estrogen/progestin postmenopausal hormone therapy plummeted and cases of cardiovascular disease and breast cancer declined. It is estimated that results from the WHI hormone trials alone have saved $35.2 billion in direct medical costs in the United States.
WHI will continue to make significant strides for women and heart disease. While we applaud Rose for her exercise regimen, we still need research to understand what levels of physical activity are needed to reduce the occurrence of heart attacks and stroke in older women. The WHI has recently begun such a study as well as one to determine whether a multivitamin and other dietary supplements might have the potential to prevent cardiovascular disease and cancer in women aged 65 and older.
The WHI is but one example of our dedication to research on women’s health. Excluding WHI, nearly half of participants in NHLBI-supported cardiovascular clinical trials are women. By studying both sexes we have identified clear differences in how cardiovascular disease affects men and women, which has led to changes in clinical practice.
The importance of research on women’s health cannot be stated enough as we continue to make progress on the following fronts:
- Examining sex as an important biological variable in research studies of disease mechanisms;
- Reflecting the demographics of the population in clinical and early translational research and reporting outcomes of studies by sex/gender; and
- Understanding and developing models to remove the barriers to the implementation of evidence-based practices that address sex-specific risks, prevention, and treatment interventions.
Towards this end, NHLBI has and will continue to solicit input from the community through scientific roundtables and our current Strategic Visioning process that will define the future research agenda for the NHLBI, including women’s health research.
NHLBI is committed to working together with researchers, industry, and advocacy groups to facilitate a comprehensive approach to women’s health research. It is the only way that we will be successful in reducing and preventing heart, lung, blood, and sleep disorders among all women. Again, critical to our success is who chooses to participate in scientific research. We appreciate the courage and altruism of the Marions and Roses of the world who have participated in clinical trials so that women might fully realize the benefits of biomedical research. WHI participant Mary Lou Frost of Buffalo, NY says it best:
“I found that my spirits were buoyed just by the experience of knowing that I was doing something that would make a great deal of difference in the future to others.”
Thank you Mary Lou, Marion, Rose and all of the women who enrolled in WHI and in other scientific trials. Progress would not be possible without you.
- Health and financial analysis reinforces NIH’s decision to fund Women’s Health Initiative: http://www.nhlbi.nih.gov/news/press-releases/2014/health-and-financial-analysis-reinforces-nihs-decision-to-fund-womens-health-initiative
- Women’s Health Initiative Homepage: https://www.whi.org/SitePages/WHI%20Home.aspx
- Women’s Health Initiative reaffirms use of short-term hormone replacement therapy for younger women: http://www.nhlbi.nih.gov/news/press-releases/2013/womens-health-initiative-reaffirms-use-of-short-term-hormone-replacement-therapy-for-younger-women
- Women’s Health Initiative Data to be Used in New Genomics-Based Studies: http://www.nhlbi.nih.gov/news/spotlight/fact-sheet/women%E2%80%99s-health-initiative-data-be-used-new-genomics-based-studies
- Director’s Corner: Women’s Health: A Legacy of Commitment: http://www.nhlbi.nih.gov/about/directorscorner/messages/womens-health-legacy-commitment-%E2%80%A6
- Heroines of the Women's Health Initiative: https://www.nhlbi.nih.gov/news/spotlight/fact-sheet/heroines-womens-health-initiative