Abstract:
OBJECTIVES:To review completed trials assessing effect of hormone replacement therapy on subsequent risk of stroke, assessing stroke by pathological type, severity, and outcome. DESIGN:Systematic review of randomised controlled trials identified from the Cochrane Library, Embase, and Medline; reviews; and reference lists of relevant papers. STUDIES REVIEWED:28 trials, with 39 769 subjects, were identified. REVIEW MEASURES: Rates for cerebrovascular events analysed with a random effects model. Sensitivity analyses for heterogeneity included phase of prevention (primary or secondary), type of hormone replacement therapy (oestrogen alone or combined with progesterone), type of oestrogen (estradiol or conjugated equine oestrogen), size of trial (< 5000 or > 5000 patients), length of follow up ( pound 3 years or > 3 years), sex (women only or men only), and trial quality (high or low). RESULTS:Hormone replacement therapy was associated with significant increases in total stroke (odds ratio 1.29 (95% confidence interval 1.13 to 1.47), n = 28), non-fatal stroke (1.23 (1.06 to 1.44), n = 21), stroke leading to death or disability (1.56 (1.11 to 2.20), n = 14), ischaemic stroke (1.29 (1.06 to 1.56), n = 16), and a trend to more fatal stroke (1.28 (0.87 to 1.88), n = 22). It was not associated with haemorrhagic stroke (1.07 (0.65 to 1.75), n = 17) or transient ischaemic attack (1.02 (0.78 to 1.34), n = 22). Statistical heterogeneity was not present in any analysis. CONCLUSIONS:Hormone replacement therapy was associated with an increased risk of stroke, particularly of ischaemic type. Among subjects who had a stroke, those taking hormone replacement therapy seemed to have a worse outcome. Hormone replacement therapy cannot be recommended for the primary or secondary prevention of stroke.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Bath PM,Gray LJdoi
10.1136/bmj.38331.655347.8Fkeywords:
subject
Has Abstractpub_date
2005-02-12 00:00:00pages
342issue
7487eissn
0959-8138issn
1756-1833pii
bmj.38331.655347.8Fjournal_volume
330pub_type
杂志文章,meta分析,评审abstract:OBJECTIVE:To compare health behaviours during pregnancy (smoking and alcohol consumption) and after birth (initiation and duration of breast feeding) between British/Irish white mothers and mothers from ethnic minority groups; and, in mothers from ethnic minority groups, to examine whether indicators of acculturation (...
journal_title:BMJ (Clinical research ed.)
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更新日期:2008-05-10 00:00:00
abstract::Objective To estimate the incidence and prevalence of resistant hypertension among a UK population treated for hypertension from 1995 to 2015.Design Cohort study.Setting Electronic health records from the UK Clinical Practice Research Datalink in primary care.Participants 1 317 290 users of antihypertensive drugs with...
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pub_type: 杂志文章
doi:10.1136/bmj.j3984
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6722.445
更新日期:1990-02-17 00:00:00
abstract:OBJECTIVE:To determine the long term effects of antibiotic treatment for acute otitis media in young children. DESIGN:Prospective three year follow-up study within the framework of a primary care based, double blind, randomised, placebo controlled trial. SETTING:53 general practices in the Netherlands. PARTICIPANTS:...
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doi:10.1136/bmj.b2525
更新日期:2009-06-30 00:00:00
abstract:OBJECTIVE:To obtain information about the computerisation of general practice in Wales, and to enable more effective planning of educational provision for doctors and other primary health care workers. DESIGN:Postal questionnaire sent to all general practices in Wales. SUBJECTS:553 general practices, of which 401 (73...
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doi:10.1136/bmj.303.6794.93
更新日期:1991-07-13 00:00:00
abstract::Robots designed for surgery have three main advantages over humans. They have greater three dimensional spatial accuracy, are more reliable, and can achieve much greater precision. Although few surgical robots are yet in clinical trials one or two have advanced to the stage of seeking approval from the UK's Medical De...
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doi:10.1136/bmj.311.7018.1479
更新日期:1995-12-02 00:00:00
abstract:OBJECTIVES:To investigate trends in the incidence of acute pancreatitis resulting in admission to hospital, and mortality after admission, from 1963 to 1998. DESIGN:Analysis of hospital inpatient statistics for acute pancreatitis, linked to data from death certificates. SETTING:Southern England. SUBJECTS:5312 people...
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更新日期:2004-06-19 00:00:00
abstract:OBJECTIVE:To compare the implications of four widely used cholesterol screening and treatment guidelines by applying them to a population in the United Kingdom. DESIGN:Guidelines were applied to population based data from a cross sectional study of cardiovascular disease and risk factors. SETTING:Newcastle upon Tyne,...
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doi:10.1136/bmj.g5219
更新日期:2014-08-26 00:00:00
abstract:OBJECTIVE:Rapid diagnostic tests for malaria seem cost effective in standard analyses, but these do not take account of clinicians' response to test results. This study tested the impact of clinicians' response to rapid diagnostic test or microscopy results on the costs and benefits of testing at different levels of ma...
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pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.39395.696065.47
更新日期:2008-01-26 00:00:00
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pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.324.7332.274
更新日期:2002-02-02 00:00:00
abstract::Molecular techniques have revolutionised our knowledge of cell and tissue function in both health and disease. We already have new and powerful treatments based on an understanding of communication between cells by messenger molecules called cytokines. Furthermore, there is great therapeutic promise in defining molecu...
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更新日期:2006-04-08 00:00:00
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更新日期:2011-04-26 00:00:00
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doi:10.1136/bmj.308.6934.942
更新日期:1994-04-09 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章,多中心研究
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更新日期:1998-01-03 00:00:00
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journal_title:BMJ (Clinical research ed.)
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更新日期:2017-05-03 00:00:00
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doi:10.1136/bmj.319.7217.1104
更新日期:1999-10-23 00:00:00
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更新日期:2010-01-19 00:00:00
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更新日期:2011-01-25 00:00:00
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更新日期:2007-05-12 00:00:00
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更新日期:2004-07-10 00:00:00
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更新日期:2008-12-16 00:00:00
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更新日期:1989-11-04 00:00:00
abstract::Accumulating data indicate that modifications in diet may reduce the risk of cancer by as much as one third and possibly by as much as two thirds. On the basis of the existing evidence, however, it is not possible to be certain which cancers are causally related to diet and what proportion of them are due to specific ...
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pub_type: 杂志文章,评审
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更新日期:1994-06-18 00:00:00
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更新日期:1990-05-19 00:00:00
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