C. Rodriguez et al., Effect of body mass on the association between estrogen replacement therapy and mortality among elderly US women, AM J EPIDEM, 153(2), 2001, pp. 145-152
Citations number
31
Categorie Soggetti
Envirnomentale Medicine & Public Health","Medical Research General Topics
In observational studies, estrogen replacement therapy is associated with d
ecreased cardiovascular disease rates and increased breast cancer rates. Re
cent evidence suggests that the impact of estrogen use on disease outcomes
may vary by body mass. In a prospective study of 290,827 postmenopausal US
women with no history of cancer or cardiovascular disease at enrollment in
1982, the authors examined the association between postmenopausal estrogen
use and all-cause, coronary heart disease, stroke, all-cancer, and breast c
ancer death rates and whether these associations differed by body mass. Aft
er 12 years of follow-up, results from Cox proportional hazards models show
ed that all-cause death rates were lower among baseline estrogen users than
never users (rate ratio (RR) = 0.82, 95% confidence interval (CI): 0.78, 0
.87). The lowest relative risk was found for coronary heart disease (RR = 0
.66, 95% Cl: 0.58, 0.77). The inverse association between estrogen use and
coronary heart disease mortality was strongest for thin women (body mass in
dex <22 kg/m(2)) (RR = 0.49, p for interaction = 0.02). Breast cancer morta
lity did not increase with estrogen use overall, and no increased risk was
observed for thin or heavy women. in this population, the reduction in coro
nary heart disease mortality among estrogen users was greatest for thinner
women. Additional studies are needed to confirm or refute these results.