Hormone Replacement Therapy in Postmenopausal U.S. Women
Authors: Nancy L. Keating, John Z. Ayanian, Alan M. Zaslavsky
Journal: Annals of Internal Medicine (1999)

Letters16 November 1999Hormone Replacement Therapy in Postmenopausal U.S. WomenNancy L. Keating, MD, MPH, John Z. Ayanian, MD, MPP, and Alan M. Zaslavsky, PhDNancy L. Keating, MD, MPHHarvard Medical School; Boston, MA 02115 (Keating)Harvard Medical School; Boston, MA 02115 (Ayanian)Harvard Medical School; Boston, MA 02115 (Zaslavsky)Search for more papers by this author, John Z. Ayanian, MD, MPPHarvard Medical School; Boston, MA 02115 (Keating)Harvard Medical School; Boston, MA 02115 (Ayanian)Harvard Medical School; Boston, MA 02115 (Zaslavsky)Search for more papers by this author, and Alan M. Zaslavsky, PhDHarvard Medical School; Boston, MA 02115 (Keating)Harvard Medical School; Boston, MA 02115 (Ayanian)Harvard Medical School; Boston, MA 02115 (Zaslavsky)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-10-199911160-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Singh offers a plausible physiologic explanation why obese women might be less likely to be taking HRT. In our multivariate analysis, we used a waist-to-hip ratio of more than 0.85 as a marker of obesity because central adiposity is strongly correlated with risk for coronary heart disease in women (1) and might be an important confounder of HRT use. However, women with an increased waist-to-hip ratio were not statistically less likely to use HRT than other women.As Dr. Singh infers, most of the diabetic women in our sample were overweight (78% had a waist-to-hip ratio >0.85 and ...References1. Rexrode KM, Carey VJ, Hennekens CH, Walters EE, Colditz GA, Stampfer MJ, et al . Abdominal adiposity and coronary heart disease in women. JAMA. 1998;280:1843-8. CrossrefMedlineGoogle Scholar2. Redelmeier DA, Tan SH, Booth GL. The treatment of unrelated disorders in patients with chronic medical diseases. N Engl J Med. 1998;338:1516-20. CrossrefMedlineGoogle Scholar3. Espeland MA, Hogan PE, Fineberg SE, Howard G, Schrott H, Waclanin MA, et al . Effect of postmenopausal hormone therapy on glucose and insulin concentrations. PEPI Investigators. Postmenopausal Estrogen/Progestin Interventions. Diabetes Care. 1998;21:1589-95. CrossrefMedlineGoogle Scholar4. Solomon CG, Hennekens CH, Stampfer MJ, Colditz GA, Willett WC, Rich-Edwards J, et al . Postmenopausal estrogen therapy is associated with reduced risk for coronary heart disease in women with non–insulin-dependent diabetes mellitus [Abstract]. Circulation. 1996;94 Suppl 1 I339. Google Scholar5. Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B, et al . Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA. 1998;280:605-13. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Harvard Medical School; Boston, MA 02115 (Keating)Harvard Medical School; Boston, MA 02115 (Ayanian)Harvard Medical School; Boston, MA 02115 (Zaslavsky) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUse of Hormone Replacement Therapy by Postmenopausal Women in the United States Nancy L. Keating , Paul D. Cleary , Alice S. Rossi , Alan M. Zaslavsky , and John Z. Ayanian Hormone Replacement Therapy in Postmenopausal U.S. Women Pramil N. Singh Metrics Cited ByAcute LPS exposure increases synaptosomal metabolism during estrus but not diestrus 16 November 1999Volume 131, Issue 10Page: 791KeywordsCoronary heart diseaseGlucose toleranceHormone replacement therapyLongitudinal studiesMultivariate analysisObesityOdds ratioOverweightRandomized trialsRisk management Issue Published: 16 November 1999 CopyrightCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...