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February 18, 1983

Estrogen Use and All-Cause Mortality: Preliminary Results From the Lipid Research Clinics Program Follow-up Study

Author Affiliations

From the Oklahoma Medical Research Foundation, Oklahoma City (Drs Bush and Cowan); the Department of Community Medicine, School of Medicine, University of California (San Diego), La Jolla (Drs Barrett-Connor and Criqui); the Departments of Biostatistics (Dr Karon) and Epidemiology (Dr Tyroler), School of Public Health, University of North Carolina, Chapel Hill; the Department of Preventive Medicine and Environmental Health, University of Iowa College of Medicine, Iowa City (Dr Wallace); and the Lipid Metabolism-Atherogenesis Branch, Division of Heart and Vascular Diseases, National Heart, Lung, and Blood Institute, Bethesda, Md (Dr Rifkind).

JAMA. 1983;249(7):903-906. doi:10.1001/jama.1983.03330310033022

The association of exogenous estrogen use and hysterectomy status with all-cause mortality was examined in 2,269 white women, aged 40 to 69 years, who had been followed up for an average of 5.6 years in the Lipid Research Clinics Program Follow-up Study. A total of 72 deaths occurred during this period. The relative risk of death in estrogen users compared with nonusers was 0.54 in gynecologically intact women, 0.34 in hysterectomized women, and 0.12 in bilaterally oophorectomized women. The risk of death in estrogen users, irrespective of hysterectomy status, was 0.37 times that in nonusers (3.4/1,000 v 9.3/1,000). The significant negative association of estrogen use with mortality persisted after multivariate adjustment for confounding factors. Hysterectomy status alone was not a significant predictor of death. Some, but not all, of the lower risk of mortality in estrogen users can be accounted for by increased levels of high-density lipoprotein cholesterol.

(JAMA 1983;249:903-906)

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