Commentary: hormone replacement therapy and coronary heart disease: four lessons.

In 1991, Stampfer and Colditz, 1 reviewing epidemiological studies of the effect of postmenopausal oestrogen on coronary heart disease concluded that: ‘… the bulk of evidence strongly supports a protective effect of estrogens that is unlikely to be explained by confounding factors …’ Their best estimate of the relative risk of coronary heart disease (CHD) in postmenopausal oestrogen users was calculated using meta-analytical techniques applied to the epidemiological studies they deemed to be of high quality based on their designs—prospective studies with internal controls and angiographic studies. This estimate was 0.50. The CI was narrow � 0.43 to 0.56.

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