Hormone therapy and mortality during a 14-year follow-up of 14 324 Norwegian women
Hormone therapy and mortality during a 14-year follow-up of 14 324 Norwegian women
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DOI：
10.1111/j.1365-2796.2004.01396.x
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发表时间：
2004-11-01
影响因子：
11.1
通讯作者：
Tonstad, S
中科院分区：
文献类型：
--
作者：
Graff-Iversen, S;Hammar, N;Tonstad, S
目标.我们评估了心血管疾病（CVD）、冠心病（CHD）和所有与使用任何激素治疗（HT）以及使用雌二醇和炔诺酮或左炔诺孕酮的HT相关的原因的死亡率。基于人群的队列研究。环境和受试者。1985- 1988年，挪威三个郡的妇女应邀参加了一次健康调查，82.8%的妇女参加了调查。对14324例绝经后或围绝经期妇女进行了14年的随访，其中包括702例HT使用者，平均年龄48.8岁。使用FIT的妇女与不使用者的所有原因和CVD的死亡率相当。所有女性中，HT使用者CVD死亡的相对风险（RR）为0.69（95%CI：0.35-1.33），HT与炔诺酮或左炔诺孕酮使用者为0.96（95%CI：0.43-2.17）。在基线时无自报心血管健康问题的女性中，所有原因的心血管疾病和冠心病死亡率在HT使用者中往往较低，而HT使用与心血管健康问题女性的死亡率增加有关。在这个队列中，在正常绝经年龄的妇女中，HT使用者（最常见的是雌二醇联合炔诺酮或左炔诺孕酮）的全因或CVD死亡率与非使用者无显著差异。HT使用者在基线调查之前的早期CHD事件，以及选择性纳入健康受试者，可能部分解释了HT对既往观察性研究报告的CHD的保护作用。
Objectives. We evaluated mortality from cardiovascular disease (CVD), coronary heart disease (CHD) and all causes in relation to use of any hormone therapy (HT) and HT with oestradiol and norethisterone or levonorgestrel.Design. Population-based cohort study.Setting and subjects. Women in three Norwegian counties were invited to a health survey in 1985-88 and 82.8% participated. In all 14 324 post- or perimenopausal women aged 35-62 years, including 702 HT users with a mean age of 48.8 years, were followed for 14 years.Results. Women using FIT had mortality from all causes and CVD comparable with that of nonusers. The relative risk (RRs) for CVD mortality amongst all women were 0.69 (95% CI: 0.35-1.33) for users of HT, and 0.96 (95% CI: 0.43-2.17) for users of HT with norethisterone or levonorgestrel. Amongst women free of self-reported cardiovascular health problems at baseline all-cause, CVD and CHD mortality tended to be lower amongst users of HT whilst HT use was linked with increased mortality amongst women with cardiovascular health problems.Conclusions. In this cohort of women around the usual age of menopause all-cause or CVD mortality amongst users of HT, most often oestradiol combined with norethisterone or levonorgestrel, was not markedly different from that of nonusers. Early CHD events amongst HT users prior to the baseline survey, together with selective inclusion of healthy subjects, may in part explain protective effects of HT on CHD reported from previous observational studies.