Francine Grodstein, ScD; JoAnn E. Manson, MD; Meir J. Stampfer, MD
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Grodstein F, Manson JE, Stampfer MJ. Postmenopausal Hormone Replacement Therapy. Ann Intern Med. 2003;138:688. doi: 10.7326/0003-4819-138-8-200304150-00028
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Published: Ann Intern Med. 2003;138(8):688.
TO THE EDITOR:
Humphrey and colleagues (1) claimed incorrectly that the Nurses' Health Study failed to control for socioeconomic status in analyzing postmenopausal hormones and risk for coronary heart disease (CHD). All of our participants are registered nurses, with nearly identical education. Thus, using stratification, we adjusted for profession and education (2) to an equivalent extent as studies that Humphrey and colleagues cited as having adequately adjusted for socioeconomic status. Other large cohorts, such as the Leisure World Study (3), similarly control for confounding by focusing on populations with uniform income and education. Moreover, Humphrey and colleagues incorrectly stated that studies controlling for alcohol or physical activity failed to observe lower risk for CHD among hormone users. After adjustment for alcohol and physical activity, we reported a 36% lower risk for CHD among current users versus never-users (2).
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