Postmenopausal estrogen use, cigarette smoking, and cardiovascular morbidity in women over 50. The Framingham Study.
Postmenopausal estrogen use, cigarette smoking, and cardiovascular morbidity in women over 50. The Framingham Study.
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50 岁以上女性绝经后雌激素的使用、吸烟和心血管发病率。弗雷明汉研究。
DOI：
10.1097/00006254-198605000-00016
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发表时间：
1985
期刊：
影响因子：
--
通讯作者：
W. Castelli
中科院分区：
文献类型：
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作者：
P. Wilson;R. Garrison;W. Castelli
我们研究了1234名年龄在50 - 83岁的绝经后妇女使用雌激素对心血管疾病发病率的影响，这些妇女参加了第12届心脏研究两年一次的检查（指数检查）。在每两年一次的检查8 - 12中记录的用药史被用来对雌激素暴露的程度进行分类，然后观察8年的心血管发病率和死亡率。尽管心血管疾病的风险特征良好，并且对已知的主要心脏病风险因素进行了控制，但在一次或多次检查中报告绝经后使用雌激素的女性在指数检查后心血管疾病发病率增加了50%以上（P <0.01），脑血管疾病的风险增加了两倍以上（P <0.01）。特别是在吸烟的雌激素使用者中，观察到心肌梗死的发生率增加（P <0.05）。相反，在非吸烟者中，雌激素的使用仅与中风发病率的增加相关（P <0.05）。在研究组中没有观察到使用雌激素的益处;特别是，所有原因和心血管疾病的死亡率在雌激素使用者和非使用者之间没有差异。
We studied the effect of estrogen use on morbidity from cardiovascular disease in 1234 postmenopausal women, aged 50 to 83 years, participating in the Framingham Heart Study's 12th biennial examination (index examination). The medication history recorded at biennial examinations 8 through 12 was used to classify the degree of estrogen exposure before eight years of observation for cardiovascular morbidity and mortality. Despite a favorable cardiovascular risk profile and control for the major known risk factors for heart disease, women reporting postmenopausal estrogen use at one or more examinations had over a 50 per cent elevated risk of cardiovascular morbidity (P less than 0.01) and more than a twofold risk for cerebrovascular disease (P less than 0.01) after the index examination. Increased rates for myocardial infarction (P less than 0.05) were observed particularly among the estrogen users who smoked cigarettes. Conversely, among nonsmokers estrogen use was associated only with an increased incidence of stroke (P less than 0.05). No benefits from estrogen use were observed in the study group; in particular, mortality from all causes and from cardiovascular disease did not differ for estrogen users and nonusers.