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Cited by 1,241Menopause: Health Impacts and TreatmentsEstrogen and related hormone effectsHormonal and reproductive studies

Estrogen and coronary heart disease in women

Barrett-Connor, Elizabeth·1991·JAMA: The Journal of the American Medical Association
DOI 10.1001/jama.1991.03460140089033
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Abstract

We review herein the evidence that estrogen is protective against the development of cardiovascular disease in women. To our knowledge, no studies in women have looked at endogenous estrogen levels as predictors of cardiovascular disease. Studies of surrogate measures of endogenous estrogen such as parity, age at menarche, and age at menopause have provided inconsistent results. Current use of oral contraceptives increases risk in older women who smoke cigarettes, but most studies of past use show no increased risk. Most, but not all, studies of hormone replacement therapy in postmenopausal women show around a 50% reduction in risk of a coronary event in women using unopposed oral estrogen. These important observations need to be confirmed in a double-blind, randomized clinical trial, since the protection is biologically plausible and the magnitude of the benefit would be quite large if selection factors can be excluded.

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Crossref · 10.1001/jama.1991.03460140089033

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83 of 83 references verified0 citation errors · 0 not checkable

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  • One included study was an observational analysis of CV events of a randomized trial evaluating electrocautery of ovaries versus gonadotropins in women with clomiphene-resistant polycystic ovarian syndrome.

    “One included study (35) was an observational analysis of CV events of a randomized trial evaluating electrocautery of ovaries versus gonadotropins in women with clomipheneresistant polycystic ovarian syndrome (36).”

    From Cardiovascular Risk Following Fertility Therapy (2017) · cites this paper as [35]

  • One included study was judged to have an overall serious risk of bias resulting from vague ascertainment and classification of CV outcomes.

    “One included study was judged to have an overall serious risk of bias resulting from vague ascertainment and classification of CV outcomes (35).”

    From Cardiovascular Risk Following Fertility Therapy (2017) · cites this paper as [35]

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Authors
Barrett-Connor, E.
Affiliations
University of California San Diego (US)
Corresponding author
Barrett-Connor, Elizabeth
ORCID
Barrett-Connor, Elizabeth
Venue
JAMA: The Journal of the American Medical Association
Publisher
American Medical Association (AMA)
Published
1991-04-10
Volume
265
Issue
14
Pages
1861
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.1991.03460140089033
OpenAlex
W2018312028
Cited by
1,241
References
83
Citations by year
2026: 9 · 2025: 13 · 2024: 7 · 2023: 10 · 2022: 9 · 2021: 17 · 2020: 11 · 2019: 11 · 2018: 7 · 2017: 21 · 2016: 16 · 2015: 23 · 2014: 19 · 2013: 26 · 2012: 23
FWCI
31.72
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Estrogen and related hormone effects
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords
estrogen, coronary artery disease, women, cardiovascular disease, endogenous estrogen, parity, age at menarche, age at menopause, oral contraceptives, smoking, hormone replacement therapy, postmenopausal women, unopposed estrogen
MeSH terms
Age Factors, Contraceptives, Oral, Hormonal, Coronary Disease, Estrogens, Female, Humans, Menopause, Menstruation, Parity, Risk Factors, Sex Factors, Estrogen Replacement Therapy

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