Postmenopausal Estrogen and Progestin Use and the Risk of Cardiovascular Disease
New England Journal of MedicinePublished 15 August 1996Open access
Francine Grodstein, Meir J. Stampfer, JoAnn E. Manson, Graham A. Colditz, Walter C. Willett, Bernard Rosner
Citations1,318
SJR quartileQ1
SJR score19.08
SNIP13.47
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The addition of progestin does not appear to attenuate the cardioprotective effects of postmenopausal estrogen therapy, and there was no significant association between stroke and use of combined hormones.
Abstract
The addition of progestin does not appear to attenuate the cardioprotective effects of postmenopausal estrogen therapy.
Keywords
MedicineBiochemistry, Genetics and Molecular Biology
Journal of the Royal Statistical Society Series B (Statistical Methodology)Regression Models and Life-Tables
39,259 Citations1972D. R. Cox
American Journal of EpidemiologyREPRODUCIBILITY AND VALIDITY OF A SEMIQUANTITATIVE FOOD FREQUENCY QUESTIONNAIRE
4,315 Citations1985Walter C. Willett, Laura Sampson +6 more
Data indicate that a simple self-administered dietary questionnaire can provide useful information about individual nutrient intakes over a one-year period.
Annals of Internal MedicineHormone Therapy To Prevent Disease and Prolong Life in Postmenopausal Women
2,353 Citations1992D Grady, Susan M. Rubin +6 more
New England Journal of MedicinePostmenopausal Estrogen Therapy and Cardiovascular Disease
1,999 Citations1991Meir J. Stampfer, Graham A. Colditz +5 more
New England Journal of MedicineThe Use of Estrogens and Progestins and the Risk of Breast Cancer in Postmenopausal Women
1,509 Citations1995Graham A. Colditz, Susan E. Hankinson +7 more
The addition of progestins to estrogen therapy does not reduce the risk of breast cancer among postmenopausal women and the substantial increase in the risk among older women who take hormones suggests that the trade-offs between risks and benefits should be carefully assessed.
American Journal of EpidemiologyTEST OF THE NATIONAL DEATH INDEX
792 Citations1984Meir J. Stampfer, Walter C. Willett +5 more
Arteriosclerosis An Official Journal of the American Heart Association IncInhibition of coronary artery atherosclerosis by 17-beta estradiol in ovariectomized monkeys. Lack of an effect of added progesterone.
605 Citations1990Michael R. Adams, Jay R. Kaplan +5 more
It is concluded that physiologic estrogen replacement Therapy with or without added progesterone inhibits atherosclerosis progression in ovariectomized monkeys, which may explain why estrogen replacement therapy results in reduced risk of coronary heart disease in postmenopausal women.
JAMAEffects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women. The Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial. The Writing Group for the PEPI Trial
605 Citations1995Valery T. Miller, John C. LaRosa +93 more
American Journal of EpidemiologyCIGARETTE SMOKING, RELATIVE WEIGHT, AND MENOPAUSE
557 Citations1983Walter C. Willett, Meir J. Stampfer +6 more
Current smokers were more likely than past or never smokers to develop menopause, although the effects of smoking diminished with age, and the effect of relative weight was in part explained by the tendency of current smokers to weigh less than nonsmokers.
American Journal of EpidemiologyPrior to Use of Estrogen Replacement Therapy, Are Users Healthier than Nonusers?
523 Citations1996Karen A. Matthews, Lewis H. Kuller +3 more
Women who elect to use ERT have a better cardiovascular risk factor profile prior to the use of ERT than do women who subsequently do not use this treatment during the menopause, which supports the hypothesis that part of the apparent benefit associated with the useof ERT is due to preexisting characteristics of women who useERT.
The LancetOestrogen and inhibition of oxidation of low-density lipoproteins in postmenopausal women
523 Citations1994Michael N. Sack, D J Rader +1 more
An antioxidant effect of physiological levels of 17 beta-oestradiol, which may contribute to an anti-atherogenic action is shown in 18 postmenopausal women.
Obstetrics and GynecologyEstrogen Replacement Therapy II: A Prospective Study in the Relationship to Carcinoma and Cardiovascular and Metabolic Problems
451 Citations1979Lila E. Nachtigall, R. Nachtigall +2 more
Results revealed no statistically significant difference in that incidence of thrombophlebitis, myocardial infarction (MI), or uterine cancer, and patients in the treated group who began the study with elevated beta/alpha lipoprotein ratios showed a reduction in that ratio over the course of the study.
American Journal of EpidemiologyREPRODUCIBILITY AND VALIDITY OF SELF-REPORTED MENOPAUSAL STATUS IN A PROSPECTIVE COHORT STUDY
442 Citations1987Graham A. Colditz, Meir J. Stampfer +5 more
The reproducibility and validity of self-reported menopausal status were evaluated among the 121,700 female US registered nurses aged 30-55 years in 1976 who are participants in the Nurses' Health Study, a prospective cohort study of diseases in women.
Progress in Cardiovascular DiseasesThe epidemiology of coronary heart disease and estrogen replacement in postmenopausal women
422 Citations1995Francine Grodstein, M. J. Stampfer
Evidence from epidemiological studies indicates that estrogen replacement therapy in postmenopausal women can reduce their risk of coronary heart disease and the effect of progestin added to estrogen therapy has not been adequately assessed, but initial evidence suggests that it may somewhat attenuate, although not completely eliminate, the benefits of estrogen on cardiovascular disease.
The LancetPulsatility index in internal carotid artery in relation to transdermal oestradiol and time since menopause
389 Citations1991David Crook, HB Meire +4 more
Results suggest that oestrogen has a generalised effect on the arterial system, and previous observations of a reduction in uterine artery PI with oestradiol treatment, suggest that this protection against cardiovascular disease is not fully explained by changes in plasma lipoproteins.
Annals of Internal MedicinePostmenopausal Estrogen and Prevention Bias
379 Citations1991Elizabeth Barrett‐Connor
In the last decade many investigators reported that postmenopausal women taking estrogen were at reduced risk for cardiovascular disease compared with women not taking estrogen.
BJOG An International Journal of Obstetrics & GynaecologyThe risk of acute myocardial infarction after oestrogen and oestrogen‐progestogen replacement
343 Citations1992Margareta Falkeborn, Ingemar Persson +6 more
The relative risk of developing a first acute myocardial infarction after treatment with oestrogens alone or oestrogen‐progestogen combinations is determined.
StrokeStroke incidence and risk factors for stroke in Copenhagen, Denmark.
285 Citations1988Gudrun Boysen, J Nyboe +6 more
Among the 16 potential risk factors for stroke in Copenhagen, Denmark, significant effects were found for age, sex, household income, smoking habits, systolic blood pressure, diabetes, plasma cholesterol concentration, ischemic heart disease, and atrial fibrillation.
American Journal of Obstetrics and GynecologyPrevalence and determinants of estrogen replacement therapy in elderly women
282 Citations1990Jane A. Cauley, Steven R. Cummings +3 more
Archives of Internal MedicineThe risk of myocardial infarction associated with the combined use of estrogens and progestins in postmenopausal women
278 Citations1994Bruce M. Psaty
In this case-control study, the reduced risk of myocardial infarction associated with the use of estrogens alone was consistent with previous observational studies, and the current use of combined therapy was not associated with an adverse effect on the incidence of my heart attack in postmenopausal women.
The LancetCardiovascular protection by oestrogen—a calcium antagonist effect?
270 Citations1993Peter Collins, Giuseppe Rosano +4 more
It is proposed that some of the cardiovascular benefits of oestrogen replacement therapy may be due to a long-term calcium antagonist effect of oedema, based on new experimental evidence.
Journal of Clinical InvestigationEstrogen and progesterone replacement therapy reduces low density lipoprotein accumulation in the coronary arteries of surgically postmenopausal cynomolgus monkeys.
255 Citations1991Janice D. Wagner, T.B. Clarkson +4 more
Results of this study suggest that one mechanism by which sex hormone treatment inhibits the initiation of atherosclerosis is a direct effect at the level of the arterial wall by suppressing the uptake and/or degradation of LDL.
BJOG An International Journal of Obstetrics & GynaecologyMortality in a cohort of long‐term users of hormone replacement therapy: an updated analysis
228 Citations1990Kate Hunt, Martin Vessey +1 more
To reexamine the mortality experience of a cohort of long‐term users of hormone replacement therapy (HRT) in comparison with that reported previously for the same cohort of women, paying particular attention to cardiovascular mortality, deaths from breast and endometrial cancer, and deaths attributed to suicide or suspected suicide.
Journal of Clinical InvestigationEstrogen monotherapy and combined estrogen-progestogen replacement therapy attenuate aortic accumulation of cholesterol in ovariectomized cholesterol-fed rabbits.
202 Citations1991Jens Haarbo, Per Leth-Espensen +2 more
It is shown that estrogen attenuates atherogenesis in cholesterol-fed ovariectomized rabbits and that two commonly prescribed progestogens do not counteract the effect, indicating that estradiol possesses additional beneficial effects, possibly a direct action on the arterial wall.
The EndocrinologistTreatment of the Postmenopausal Woman
196 Citations1995Rogerio A. Løbo, Ann E. Taylor +1 more
American Journal of Obstetrics and GynecologyThe effects of hormone replacement therapy in normal postmenopausal women: Measurements of Doppler-derived parameters of aortic flow
180 Citations1991Amos Pines, Enrique Z. Fisman +9 more
It is demonstrated that estrogens increase both stroke volume and flow acceleration in healthy postmenopausal women, which probably reflects a combination of enhanced inotropism and vasodilatation.
Journal of Epidemiology & Community HealthThe use of hormonal replacement therapy and the risk of stroke and myocardial infarction in women.
119 Citations1989S.G. Thompson, T W Meade +1 more
There is no evidence that the use of HRT as recently prescribed in the UK constitutes a major cardiovascular risk or benefit and the observed gradients of risk according to the duration and time since HRT use do not support a causal interpretation.
Archives of Internal MedicineDecreased mortality in users of estrogen replacement therapy
115 Citations1991B E Henderson
Obstetrics and GynecologyEffects of Conjugated Equine Estrogen With and Without Three Different Progestogens on Lipoproteins, High-Density Lipoprotein Subfractions, and Apolipoprotein A-I
109 Citations1991Valery T. Miller, Richard A. Muesing +4 more
After 3 months of treatment, all three progestogens reversed some of the favorable effects of unopposed estrogen on lipoproteins but permitted a continued modest reduction in LDL cholesterol.
American Journal of Obstetrics and GynecologyAngina and normal coronary arteries in women: Gynecologic findings
80 Citations1992Philip M. Sarrel, David Lindsay +2 more
The incidence of hysterectomy was increased and estrogen replacement therapy alleviated cardiac symptoms and enhanced hyperemic response in a group of women with syndrome X.