Finucane F F, Madans J H, Bush T L, Wolf P H, Kleinman J C
Office of Analysis and Epidemiology, National Center for Health Statistics, Hyattsville, Md.
Arch Intern Med. 1993 Jan 11;153(1):73-9.
To assess the impact of postmenopausal hormone use on the risk of stroke incidence and stroke mortality.
Longitudinal study consisting of three data collection waves. The average follow up for cohort members was 11.9 years (maximum, 16.3 years). Cox proportional hazards regression models were used to estimate the relative risk of stroke for postmenopausal hormone ever-users compared with never-users.
A national sample of 1910 (of 2371 eligible) white postmenopausal women who were 55 to 74 years old when examined in 1971 through 1975 as part of the first National Health and Nutrition Examination Survey and who did not report a history of stroke at that time.
The main outcome measure was incident stroke (fatal and nonfatal). Events were determined from discharge diagnosis information coded from hospital and nursing home records and cause of death information coded from death certificates collected during the follow-up period (1971 through 1987).
There were 250 incident cases of stroke identified, including 64 deaths with stroke listed as the underlying cause. The age-adjusted incidence rate of stroke among postmenopausal hormone ever-users was 82 per 10,000 woman-years of follow-up compared with 124 per 10,000 among never-users. Postmenopausal hormone use remained a protective factor against stroke incidence (relative risk, 0.69; 95% confidence interval, 0.47 to 1.00) and stroke mortality (relative risk, 0.37; 95% confidence interval, 0.14 to 0.92) after adjusting for the baseline risk factors of age, systolic blood pressure, diabetes, body mass index, smoking, history of hypertension and heart attack, and socioeconomic status.
The results suggest that postmenopausal hormone use is associated with a decrease in risk of stroke incidence and mortality in white postmenopausal women.
评估绝经后激素使用对中风发病率和中风死亡率风险的影响。
纵向研究，包括三轮数据收集。队列成员的平均随访时间为11.9年（最长16.3年）。采用Cox比例风险回归模型来估计曾经使用绝经后激素的女性与从未使用者相比发生中风的相对风险。
1910名（共2371名符合条件者）白人绝经后女性的全国样本，她们在1971年至1975年接受检查时年龄为55至74岁，作为第一次全国健康和营养检查调查的一部分，且当时未报告有中风病史。
主要结局指标为中风事件（致命和非致命）。事件通过对随访期间（1971年至1987年）从医院和疗养院记录中编码的出院诊断信息以及从死亡证明中编码的死亡原因信息来确定。
共确定250例中风事件，其中64例死亡，中风被列为根本死因。绝经后激素曾经使用者中中风的年龄调整发病率为每10000女性年随访82例，而从未使用者中为每10000例124例。在调整了年龄、收缩压、糖尿病、体重指数、吸烟、高血压和心脏病发作史以及社会经济地位等基线风险因素后，绝经后激素使用仍然是中风发病率（相对风险，0.69；95%置信区间，0.47至1.00）和中风死亡率（相对风险，0.37；95%置信区间，0.14至0.92）的保护因素。
结果表明，绝经后激素使用与白人绝经后女性中风发病率和死亡率风险降低有关。
