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IJE Advance Access originally published online on May 27, 2004
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International Journal of Epidemiology, Volume 33, Number 3, pp. 445-453
IJE vol.33 no.3 © International Epidemiological Association 2004; all rights reserved.

Reprints and Reflections

Estrogen replacement therapy and coronary heart disease: a quantitative assessment of the epidemiologic evidence1,,2

Meir J Stampfer, M.D.*,{dagger},3 and Graham A Colditz, M.D.*,{ddagger}

* The Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts; {dagger} Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; and {ddagger} Technology Assessment Group, Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts

Accepted 19 July 1990

Received 21 May 1990

The first 150 words of the full text of this article appear below.

Considerable epidemiological evidence has accumulated regarding the effect of post-menopausal estrogens on coronary heart disease risk. Five hospital-based case-control studies yielded inconsistent but generally null results; however, these are difficult to interpret due to the problems in selecting appropriate controls. Six population-based case-control studies found decreased relative risks among estrogen users, though only 1 was statistically significant. Three cross-sectional studies of women with or without stenosis on coronary angiography each showed markedly less atherosclerosis among estrogen users. Of 16 prospective studies, 15 found decreased relative risks, in most instances, statistically significant. The Framingham study alone observed an elevated risk, which was not statistically significant when angina was omitted. A reanalysis of the data showed a nonsignificant protective effect among younger women and a nonsignificant increase in risk among older women. Overall, the bulk of the evidence strongly supports a protective effect of estrogens that is unlikely to be explained by . . . [Full Text of this Article]


   Introduction
 

   Methods for quantitative overview
 

   Hospital-based case-control studies
 

   Population-based case-control studies
 

   Cross-sectional studies
 

   Prospective studies
 

   Results of the quantitative overview
 

   Discussion
 

   Conclusion
 

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