POSTMENOPAUSAL ESTROGEN-TREATMENT AND STROKE - A PROSPECTIVE-STUDY
POSTMENOPAUSAL ESTROGEN-TREATMENT AND STROKE - A PROSPECTIVE-STUDY
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DOI：
10.1136/bmj.297.6647.519
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发表时间：
1988-08-20
影响因子：
105.7
通讯作者：
HENDERSON, BE
中科院分区：
文献类型：
--
作者：
PAGANINIHILL, A;ROSS, RK;HENDERSON, BE
研究目的：确定绝经后雌激素的使用是否影响死于中风的风险。设计-邮寄问卷调查，以了解雌激素替代疗法和潜在风险修正剂的详细信息。加州退休社区。内裤-通过邮件和电话联系的所有22，781名社区居民（白色，富裕，受过良好教育）; 13，986人（61%，中位年龄73岁）做出了回应，其中包括8，882名女性。这些人组成了死亡率随访队列，使用卫生部死亡证明。仅13例失访，显然未死亡，但34例因无雌激素使用信息而被排除。干预措施-无。终点-比较接受和未接受雌激素替代治疗的妇女中风死亡率。测量和主要结果-年龄调整的死亡率计算使用内部标准和四个年龄组。到1987年1月，队列中有1019人死亡。4962名使用雌激素替代治疗的妇女中有20名死于中风，而3845名未使用雌激素替代治疗的妇女中有43名死于中风：相对危险度0-53，95%置信区间0.31 - 0.91。在所有年龄组中均发现了保护作用，但最年轻的年龄组除外，并且不受调整可能的混杂因素（高血压、吸烟、酒精、体重指数、运动）的影响。结论：雌激素替代治疗可预防中风死亡。
Study objective-To determine whether postmenopausal oestrogen use affects the risk of dying from stroke. Design-Postal questionnaire survey to elicit details of oestrogen replacement therapy and potential risk modifiers. Setting-Californian retirement community. Participants-All 22,781 residents of community (white, affluent, well educated) contacted by mail and phone; 13,986 (61%, median age 73) responded, including 8882 women. These formed cohort for mortality follow up, using health department death certification. Only 13 to lost to follow up, apparently not deceased, but 34 excluded because no information on oestrogen use. Interventions-None. End point-Mortality rate from stroke compared in women who did and did not receive oestrogen replacement treatment. Measurements and main results-Age adjusted mortality rates were computed using internal standard and four age groups. By January 1987 there had been 1019 deaths in the cohort. Twenty out of 4962 women who used oestrogen replacement treatment died from stroke compared with 43 out of 3845 women who did not use oestrogen replacement treatment: relative risk 0-53, 95% confidence interval 0.31 to 0.91. Protection was found in all age groups except the youngest and was unaffected by adjustment for possible confounding factors (hypertension, smoking, alcohol, body mass index, exercise). Conclusions-Oestrogen replacement treatment protects against death due to stroke.