IJE Advance Access originally published online on May 27, 2004
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International Journal of Epidemiology, Volume 33, Number 3, pp. 457-459
IJE vol.33 no.3 © International Epidemiological Association 2004; all rights reserved.
Commentary |
Commentary: Observation versus intervention—what's different?
Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA 92093–0607, USA. E-mail: ebarrettconnor@ucsd.edu
| The first 10% of the full text of this article appears below. |
Women have coronary heart disease (CHD) later than men in every country.1 This universal sex difference has been attributed to a cardioprotective effect of premenopausal oestrogen levels. Many other lines of evidence including laboratory studies support this thesis. Belief in the preventive power of endogenous oestrogen was transformed to action mainly by meta-analyses of epidemiological studies of ‘oestrogen replacement therapy’ and heart disease.
Meta-analyses pool data from separate studies weighted for sample size, thereby increasing the total number of events, increasing power, and potentially providing statistically significant results (and narrow CI) not observed in individual studies. One of the first meta-analyses of hormone therapy and CHD is the 1991 paper by Stampfer and Colditz2 reproduced here. The authors reported an overall relative risk (RR) of 0.56 (95% CI: 0.50, 0.61) based on pooled data from all 31 publications reviewed, and an RR of 0.50 (95% CI: 0.43, 0.56) based
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Participants |
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Age
Health
Socioeconomic status
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Treatment |
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The oestrogen
The progestogen
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