IJE Advance Access originally published online on May 27, 2004
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International Journal of Epidemiology, Volume 33, Number 3, pp. 454-455
IJE vol.33 no.3 © International Epidemiological Association 2004; all rights reserved.
Commentary |
Commentary: Hormones and heart disease: do trials and observational studies address different questions?
Harvard School of Public Health, Department of Epidemiology, 677 Huntington Avenue, Kresge 904, Boston, MA 02115. USA. E-mail: mstampfe@hsph.harvard.edu
| The first 10% of the full text of this article appears below. |
By 1990, the number of epidemiological studies of postmenopausal hormone use and coronary heart disease (CHD) was sufficient to justify a quantitative assessment of the evidence. Divergent views of the potential effect of postmenopausal hormones on cardiovascular risk were common. On the one hand, the observation that premenopausal women had substantially lower risk for cardiovascular disease led many to suspect that oestrogens might be protective. On the other hand, the experience of higher risk for cardiovascular disease (though not coronary atherosclerosis) with the early oral contraceptive agents, combined with the adverse experience of oestrogen in men in the Coronary Drug Project, led many to believe that it was harmful. The drug labelling for postmenopausal hormones carried warnings of risk for an increase in cardiovascular disease.
Observational data from epidemiological studies were remarkably consistent in showing that postmenopausal hormone users tended to be
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