Endogenous estrogen exposure and cardiovascular mortality risk in postmenopausal women

被引:167
作者
de Kleijn, MJJ
van der Schouw, YT
Verbeek, ALM
Peeters, PHM
Banga, JD
van der Graaf, Y
机构
[1] Univ Utrecht, Med Ctr, Julius Ctr Gen Practice & Patient Oriented Res, NL-3508 GA Utrecht, Netherlands
[2] Univ Nijmegen, Dept Epidemiol, Fac Med, Nijmegen, Netherlands
[3] Univ Utrecht, Dept Internal Med, Med Ctr, Utrecht, Netherlands
关键词
cardiovascular diseases; estrogens; menopause; mortality;
D O I
10.1093/aje/155.4.339
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
In this study the authors investigated whether combined information on reproductive factors has additive value to the single reproductive factor age at menopause for assessing endogenous estrogen exposure and cardiovascular mortality risk in postmenopausal women. They conducted a population-based cohort study that included 9,450 postmenopausal women from Nijmegen, the Netherlands, who were aged 35-65 years at enrollment in 1975, with a median follow-up of 20.5 years. A Cox proportional hazards model and Receiver Operating Curves were used to analyze the data. Women aged 52 years or more at menopause had an 18% reduction in cardiovascular mortality (hazard ratio = 0.82, 95% confidence interval (CI): 0.69, 0.98) compared with those aged 44 years or less. Women with more than 18 years of exposure to endogenous estrogen had a statistically significant 20% reduction in cardiovascular mortality (hazard ratio = 0.80, 95 percent CI: 0.67, 0.96) compared with those who had 13 years of exposure or less. The area under the curve of the Receiver Operating Curves for the two models was identical (area under the curve = 0.67, 95 percent CI: 0.66, 0.68). This study shows that age at menopause is related to cardiovascular disease mortality and that a newly developed composite measure of endogenous estrogen exposure does not add to the predictive value of age at menopause for cardiovascular mortality.
引用
收藏
页码:339 / 345
页数:7
相关论文
共 23 条
[2]   MENOPAUSE AND THE RISK OF CORONARY HEART-DISEASE IN WOMEN [J].
COLDITZ, GA ;
WILLETT, WC ;
STAMPFER, MJ ;
ROSNER, B ;
SPEIZER, FE ;
HENNEKENS, CH .
NEW ENGLAND JOURNAL OF MEDICINE, 1987, 316 (18) :1105-1110
[3]   Age at natural menopause and mortality [J].
Cooper, GS ;
Sandler, DP .
ANNALS OF EPIDEMIOLOGY, 1998, 8 (04) :229-235
[4]   Reproductive history and cardiovascular disease risk in postmenopausal women - A review of the literature [J].
de Kleijn, MJJ ;
van der Schouw, YT ;
van der Graaf, Y .
MATURITAS, 1999, 33 (01) :7-36
[5]   THE DOM PROJECT FOR THE EARLY DETECTION OF BREAST-CANCER, UTRECHT, THE NETHERLANDS [J].
DEWAARD, F ;
COLLETTE, HJA ;
ROMBACH, JJ ;
BAANDERSVANHALEWIJN, EA ;
HONING, C .
JOURNAL OF CHRONIC DISEASES, 1984, 37 (01) :1-44
[6]  
DOSEMECI M, 1990, AM J EPIDEMIOL, V132, P746, DOI 10.1093/oxfordjournals.aje.a115716
[7]   DOES NONDIFFERENTIAL MISCLASSIFICATION OF EXPOSURE ALWAYS BIAS A TRUE EFFECT TOWARD THE NULL VALUE - REPLY [J].
DOSEMECI, M ;
WACHOLDER, S ;
LUBIN, JH .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1991, 134 (04) :441-442
[8]  
GILBERT ES, 1991, AM J EPIDEMIOL, V134, P440, DOI 10.1093/oxfordjournals.aje.a116108
[9]   MENOPAUSE AND CORONARY HEART-DISEASE - FRAMINGHAM STUDY [J].
GORDON, T ;
KANNEL, WB ;
HJORTLAND, MC ;
MCNAMARA, PM .
ANNALS OF INTERNAL MEDICINE, 1978, 89 (02) :157-161
[10]   Effective risk stratification using exercise myocardial perfusion SPECT in women: Gender-related differences in prognostic nuclear testing [J].
Hachamovitch, R ;
Berman, DS ;
Kiat, H ;
Merz, CNB ;
Cohen, I ;
Cabico, JA ;
Friedman, J ;
Germano, G ;
vanTrain, KF ;
Diamond, GA .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1996, 28 (01) :34-44