Estrogen use and all-cause mortality. Preliminary results from the Lipid Research Clinics Program Follow-Up Study

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Abstract
The association of exogenous estrogen use and hysterectomy status with all-cause mortality was examined in 2269 white women, aged 40-69 yr, who were followed for an average of 5.6 yr in the Lipid Research Clinics Program Follow-up Study. A total of 72 deaths occurred during the period. The relative risk of death in estrogen users compared with nonusers was 0.54 in gynecologically intact women, 0.34 in hysterectomized women and 0.12 in bilaterally oophorectomized women. The risk of death in estrogen users, irrespective of hysterectomy status, was 0.37 times that in nonusers (3.4/1000 vs. 9.3/1000). The significant negative association of estrogen use with mortality persisted after multivariate adjustment for confounding factors. Hysterectomy status alone was not a significant predictor of death. Some, but not all, of the lower risk of mortality in estrogen users can be accounted for by increased levels of high-density lipoprotein cholesterol [which decreases the risk of coronary heart disease].