INSÄNT AV Red DiabetologNytt DEN 02 :e NOVEMBER, 1996 vid 12 - tiden
Från en diabetesintresserad kvinnlig kardiolog på väg till American
Heart Association´s, Tema Fighting against Heart Disease and Stroke,
möte i New Orleans Nov 10-13 1996 kommer nedan färska abstract rapport
POSTMENOPAUSAL ESTROGEN THERAPY IS ASSOCIATED WITH REDUCED RISK
FOR CORONARY HEART DISEASE IN WOMEN WITH NON-INSULIN-DEPENDENT
Solomon C et al, Brigham and Women´s Hosp, Boston, MA, USA
Women with diabetes lose the cardiovascular advantage usually
conferred by female gender, and have increased risk for coronary
heart disease (CHD). Estrogen replacement therapy (ERT) has been
associated with 40-50% reduction in CHD risk among postmenopausal
women, but the role of ERT among women with NIDDM remains unclear.
To assess the association between ERT and CHD among women with
NIDDM, we studied wommen in the NURSES´ HEALTH STUDY, a prospective
study of 121 700 nurses age 30-55 yrs in 1976, who complete
biennial questionnaires on lifestyle factors and diseases.
4 489 nurses free of cardiovascular disease at baseline who reported
a diagnosis of DM at age more than 30 yrs and also reported meno-
pause were followed up to 16 yrs.
Results: During 27 748 personyears of follow-up, we documented
156 cases of CHD (non-fatal myocardial infarction (MI) or fatal
CHD) among thos group. As compared with non-diabetic nurses, women
with NIDDM had an age-adjusted relative tisk (RR) for CHD of 5.92
(confidence interval (CI) 5.07-6.90). Among women with NIDDM,
current use of ERT was associated with a significantly reduced
risk for CHD (RR 0.42 (95% CI, 00.24-0.74), as compared with never
use of ERT. The reduction in CHD risk with current ERT remained
significant after further adjustment for obesity, smoking,
parenteral MI, hypertension, high cholesterol, physical activity,
vitamin E use, aspirin use, and alcohol intake (multivariate RR
0.55 (95% CI, 0.44-0.70).
CONCLUSION Observed relative risk reductions for CHD associated with
current ERD use are comparable to those seen in non--diabetic
women. The high baseline CHD risk of women with NIDDM suggests
an even greater absolute benefiteto ERT in this population.
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