Primary prevention of stroke

New England Journal of Medicine

Volumn 333, Issue 21, 1995, Pages 1392-1400

  Bronner, Leslie L ^a,b   Kanter, Daniel S ^c   Manson, Joann E ^a,d  

^a HARVARD MEDICAL SCHOOL   (United States)

^b HARVARD SCHOOL OF PUBLIC HEALTH   (United States)

^c BRIGHAM AND WOMEN S HOSPITAL   (United States)

^d Health Plan ^*  (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; ORAL CONTRACEPTIVE AGENT; ANTIHYPERTENSIVE AGENT; ANTILIPEMIC AGENT; ANTIOXIDANT; ANTITHROMBOCYTIC AGENT; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CHOLESTEROL; CLOFIBRATE; DIURETIC AGENT; ESTROGEN; FATTY ACID; LIPID;

CEREBROVASCULAR DISEASE; DIABETES MELLITUS; DIET; ESTROGEN THERAPY; EXERCISE; FEMALE; HUMAN; HYPERCHOLESTEROLEMIA; HYPERTENSION; MALE; OBESITY; REVIEW; RISK FACTOR; SMOKING; ALCOHOL CONSUMPTION; ANTIHYPERTENSIVE THERAPY; CARDIOVASCULAR DISEASE; CEREBROVASCULAR ACCIDENT; CIGARETTE SMOKING; CLINICAL TRIAL; FAT INTAKE; GLUCOSE TOLERANCE; INCIDENCE; LIFESTYLE; META ANALYSIS; POSTMENOPAUSE; PRIMARY PREVENTION; PRIORITY JOURNAL; RISK ASSESSMENT; STROKE;

ASPIRIN; CEREBROVASCULAR DISORDERS; CONTRACEPTIVES, ORAL; DIABETES COMPLICATIONS; DIET; ESTROGEN REPLACEMENT THERAPY; EXERCISE; FEMALE; HUMANS; HYPERCHOLESTEROLEMIA; HYPERTENSION; MALE; OBESITY; RISK FACTORS; SMOKING;

EID: 0028817786     PISSN: 00284793     EISSN: 15334406     Source Type: Journal    
DOI: 10.1056/NEJM199511233332106     Document Type: Review

References (142)

1. Heart and stroke facts. Dallas: American Heart Association, 1991.
2. Stroke facts. Dallas: American Heart Association, 1988.
3. Gillum RF Stroke in blacks. Stroke 1988; 19: 1-9
4. Heart and stroke facts. Dallas: American Heart Association, 1992.
5. National Stroke Association. Cost of stroke. Stroke Clin Updates 1994; 5: 9-12
6. Soltero I, Liu K, Cooper R, Stamler J, Garside D Trends in mortality from cerebrovascular disease in the United States, 1960 to 1975. Stroke 1978; 9: 549-558
7. National Heart, Lung, and Blood Institute, National Institutes of Health. Morbidity and mortality: chartbook on cardiovascular, lung, and blood diseases. Bethesda, Md.: National Heart, Lung, and Blood Institute, 1994.
8. Garraway WM, Whisnant JP, Drury I The continuing decline in the incidence of stroke. Mayo Clin Proc 1983; 58: 520-523
9. Cooper R, Sempos C, Hsieh SC, Kovar MG Slowdown in the decline of stroke mortality in the United States, 1978-1986. Stroke 1990; 21: 1274-1279
10. Broderick JP, Phillips SJ, Whisnant JP, O'Fallon WM, Bergstralh EJ Incidence rates of stroke in the eighties: the end of the decline in stroke? Stroke 1989; 20: 577-582
11. World Health Organization. 1993 World health statistics annual. Geneva: World Health Organization, 1994.
12. Reed DM The paradox of high risk of stroke in populations with low risk of coronary heart disease. Am J Epidemiol 1990; 131: 579-588
13. Ostfeld AM A review of stroke epidemiology. Epidemiol Rev 1980; 2: 136-152
14. Causal inference in epidemiology. In: Rothman KJ. Modern epidemiology. Boston: Little, Brown, 1986:7-21.
15. Dunbabin DW, Sandercock PAG Preventing stroke by the modification of risk factors. Stroke 1990; 21: Suppl IV: IV-36
16. Phillips SJ, Whisnant JP Hypertension and the brain: the National High Blood Pressure Education Program. Arch Intern Med 1992; 152: 938-945
17. Wolf PA, Cobb JL, D'Agostino RB. Epidemiology of stroke. In: Barnett HJM, Mohr JP, Stein BM, Yatsu FM, eds. Stroke: pathophysiology, diagnosis, and management. 2nd ed. New York: Churchill Livingstone, 1992:3-27.
18. Sacco RL, Wolf PA, Bharucha NE, Subarachnoid and intracerebral hemorrhage: natural history, prognosis, and precursive factors in the Framingham Study. Neurology 1984; 34: 847-854
19. Fiebach NH, Hebert Pr, Stampfer MJ, A prospective study of high blood pressure and cardiovascular disease in women. Am J Epidemiol 1989; 130: 646-654
20. MacMahon S, Peto R, Cutler J, Blood pressure, stroke, and coronary heart disease. I. Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet 1990; 335: 765-774
21. MacMahon SW, Cutler JA, Furberg CD, Payne GH The effects of drug treatment for hypertension on morbidity and mortality from cardiovascular disease: a review of randomized controlled trials. Prog Cardiovasc Dis 1986; 29: Suppl 1: 99-118
22. Collins R, Peto R, MacMahon S, Blood pressure, stroke, and coronary heart disease. 2. Short-term reductions in blood pressure: overview of randomised drug trials in their epidemiological context. Lancet 1990; 335: 827-838
23. MRC Working Party Medical Research Council trial of treatment of hypertension in older adults: principal results. BMJ 1992; 304: 405-412
24. Dahlof B, Lindholm LH, Hansson L, Schersten B, Ekbom T, Wester PO Morbidity and mortality in the Swedish Trial in Old Patients with Hypertension (STOP-Hypertension). Lancet 1991; 338: 1281-1285
25. Working Group on Hypertension in the Elderly. Statement on hypertension in the elderly. JAMA 1986; 256: 70-74
26. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension: final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 1991; 265: 3255-3264
27. Amery A, Birkenhager W, Bulpitt C, Syst-Eur: a multicentre trial on the treatment of isolated systolic hypertension in the elderly: objectives, protocol and organization. Aging 1991; 3: 287-302
28. The 1988 report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure. Arch Intern Med 1988; 148: 1023-1038
29. National Research Council. Diet and health: implications for reducing chronic disease risk. Washington, D.C.: National Academy Press, 1989.
30. Public Health Service. Healthy People 2000 review, 1993. Washington, D.C.: Government Printing Office, 1993. (DHHS publication no. (PHS) 94-1232-1.)
31. Wilhelmsen L, Svardsudd K, Korsan-Bengtsen K, Larsson B, Welin L, Tibblin G Fibrinogen as a risk factor for stroke and myocardial infarction. N Engl J Med 1984; 311: 501-505
32. Renaud S, Blache D, Dumont E, Thevenon C, Wissendanger T Platelet function after cigarette smoking in relation to nicotine and carbon monoxide. Clin Pharmacol Ther 1984; 36: 389-395
33. Criqui MH, Wallace RB, Heiss G, Mishkel M, Schonfeld G, Jones GT Cigarette smoking and plasma high-density lipoprotein cholesterol: the Lipid Research Clinics Program Prevalence Study. Circulation 1980; 62: Suppl IV: IV-70
34. Smith JR, Landaw SA Smokers' polycythemia. N Engl J Med 1978; 298: 6-10
35. Sieffert GF, Keown K, Moore WS Pathologic effect of tobacco smoke inhalation on arterial intima. Surg Forum 1981; 32: 333-335
36. Kubota K, Yamaguchi T, Abe Y, Fugiwara T, Hutazawa J, Matsuzawa T Effects of smoking on regional cerebral blood flow in neurologically normal subjects. Stroke 1983; 14: 720-724
37. Shinton R, Beevers G Meta-analysis of relation between cigarette smoking and stroke. BMJ 1989; 298: 789-794
38. Wolf PA, D'Agostino RB, Kannel WB, Bonita R, Belanger AJ Cigarette smoking as a risk factor for stroke: the Framingham Study. JAMA 1988; 259: 1025-1029
39. Kawachi I, Colditz GA, Stampfer MJ, Smoking cessation and decreased risk of stroke in women. JAMA 1993; 269: 232-236
40. Department of Health and Human Services. The health benefits of smoking cessation: a report of the Surgeon General. Washington, D.C.: Government Printing Office, 1990. (DHHS publication no. (CDC) 90-8416.)
41. American Diabetes Association. Role of cardiovascular risk factors in prevention and treatment of macrovascular disease in diabetes. Diabetes Care 1989; 12: 573-579
42. Burchfiel CM, Curb JD, Rodriguez BL, Abbott RD, Chiu D, Yano K Glucose intolerance and 22-year stroke incidence: the Honolulu Heart Program. Stroke 1994; 25: 951-957
43. Manson JE, Colditz GA, Stampfer MJ, A prospective study of maturity-onset diabetes mellitus and risk of coronary heart disease and stroke in women. Arch Intern Med 1991; 151: 1141-1147
44. Ruderman NB, Haudenschild C Diabetes as an atherogenic factor. Prog Cardiovasc Dis 1984; 26: 373-412
45. Chakrabarti R, Meade TW Clotting factors, platelet function and fibrinolytic activity in diabetics and in a comparison group. Diabetologia 1976; 12: 383-383 abstract.
46. Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS Jr Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med 1991; 325: 147-152
47. Paffenbarger RS Jr, Wing AL Chronic disease in former college students. XI. Early precursors of nonfatal stroke. Am J Epidemiol 1971; 94: 524-530
48. Heyden S, Hames CG, Bartel A, Cassel JC, Tyroler HA, Cornoni JC Weight and weight history in relation to cerebrovascular and ischemic heart disease. Arch Intern Med 1971; 128: 956-960
49. Rhoads GG, Kagan A The relation of coronary disease, stroke, and mortality to weight in youth and in middle age. Lancet 1983; 1: 492-495
50. Shinton R, Shipley M, Rose G Overweight and stroke in the Whitehall study. J Epidemiol Community Health 1991; 45: 138-142
51. Herman B, Leyten ACM, van Luijk JH, Frenken CW, Op de Coul AA, Schulte BP An evaluation of risk factors for stroke in a Dutch community. Stroke 1982; 13: 334-339
52. Linsted K, Tonstad S, Kuzma JW Body mass index and patterns of mortality among Seventh-day Adventist men. Int J Obes 1991; 15: 397-406
53. Abbott RD, Behrens GR, Sharp DS, Body mass index and thromboembolic stroke in nonsmoking men in older middle age: the Honolulu Heart Program. Stroke 1994; 25: 2370-2376
54. Welin L, Svardsudd K, Wilhelmsen L, Larsson B, Tibblin G Analysis of risk factors for stroke in a cohort of men born in 1913. N Engl J Med 1987; 317: 521-526
55. Lapidus L, Bengtsson C, Larsson B, Pennert K, Rybo E, Sjostrom L Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden. BMJ 1984; 289: 1257-1261
56. Curb JD, Marcus EB Body fat, coronary heart disease, and stroke in Japanese men. Am J Clin Nutr 1991; 53: Suppl: 1612S-1615S
57. Higgins M, Kannel W, Garrison R, Pinsky J, Stokes J III Hazards of obesity -- the Framingham experience. Acta Med Scand Suppl 1988; 723: 23-36
58. Stromblad G, Bjorntorp P Reduced hepatic insulin clearance in rats with dietary-induced obesity. Metabolism 1986; 35: 323-327
59. Carlson LA, Boberg J, Högsedt B. Some physiological and clinical implications of lipid mobilization from adipose tissue. In: Renold AE, Cahill GF Jr, eds. Adipose tissue. Sect. V of Handbook of physiology. Washington, D.C.: American Physiological Society, 1965:625-44.
60. Horton ES The role of exercise in the treatment of hypertension in obesity. Int J Obes 1981; 5: Suppl 1: 165-171
61. Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL Increasing prevalence of overweight among US adults: the National Health and Nutrition Examination Surveys, 1960 to 1991. JAMA 1994; 272: 205-211
62. Bierman EL, Hirsch J. Obesity. In: Williams RH, ed. Textbook of endocrinology. 6th ed. Philadelphia: W.B. Saunders, 1981:907-21.
63. Abbott RD, Rodriguez BL, Burchfiel CM, Curb JD Physical activity in older middle-aged men and reduced risk of stroke: the Honolulu Heart Program. Am J Epidemiol 1994; 139: 881-893
64. Wannamethee G, Shaper AG Physical activity and stroke in British middle aged men. BMJ 1992; 304: 597-601
65. Kiely DK, Wolf PA, Cupples LA, Beiser AS, Kannel WB Physical activity and stroke risk: the Framingham Study. Am J Epidemiol 1994; 140: 608-620 [Erratum, J Epidemiol 1995;141:178.]
66. Manson JE, Stampfer MJ, Willett WC, Physical activity and incidence of coronary heart disease and stroke in women. Circulation 1995; 91: 927-927 abstract.
67. Rauramaa R, Salonen JT, Seppanen K, Inhibition of platelet aggregability by moderate-intensity physical exercise: a randomized clinical trial in overweight men. Circulation 1986; 74: 939-944
68. Patsch JR, Prasad AM, Gotto AM Jr, Patsch W High density lipoprotein. 2. Relationship of the plasma levels of this lipoprotein species to its composition, to the magnitude of postprandial lipemia, and to the activities of lipoprotein lipase and hepatic lipase. J Clin Invest 1987; 80: 341-347
69. Oberman A. Rehabilitation of patients with coronary artery disease. In: Braunwald E, ed. Heart disease: a textbook of cardiovascular medicine. 3rd ed. Vol. 2. Philadelphia: W.B. Saunders, 1988:1395-409.
70. Manson JE, Tosteson H, Ridker PM, The primary prevention of myocardial infarction. N Engl J Med 1992; 326: 1406-1416
71. Paffenbarger RS Jr, Hyde RT, Wing AL. Physical activity and physical fitness as determinants of health and longevity. In: Bouchard C, Shephard RJ, Stephens T, Sutton JR, McPherson BD, eds. Exercise, fitness and health: a consensus of current knowledge. Champaign, Ill.: Human Kinetics Books, 1990:33-48.
72. Holzbach RL, Piserchia PV, McFadden DW, Hartwell TD, Herrmann A, Fielding JE Effect of a comprehensive health promotion program on employee attitudes. J Occup Med 1990; 32: 973-978
73. Jacobs D, Blackburn H, Higgins M, Report of the Conference on Low Blood Cholesterol: mortality associations. Circulation 1992; 86: 1046-1060
74. Yano K, Reed DM, MacLean CJ Serum cholesterol and hemorrhagic stroke in the Honolulu Heart Program. Stroke 1989; 20: 1460-1465
75. Tanaka H, Ueda Y, Hayashi M, Risk factors for cerebral hemorrhage and cerebral infarction in a Japanese rural community. Stroke 1982; 13: 62-73
76. Iso H, Jacobs DR Jr, Wentworth D, Neaton JD, Cohen JD Serum cholesterol levels and six-year mortality from stroke in 350,977 men screened for the Multiple Risk Factor Intervention Trial. N Engl J Med 1989; 320: 904-910
77. Benfante R, Yano K, Hwang LJ, Curb JD, Kagan A, Ross W Elevated serum cholesterol is a risk factor for both coronary heart disease and thromboembolic stroke in Hawaiian Japanese men: implications of shared risk. Stroke 1994; 25: 814-820
78. Salonen JT, Puska P, Tuomilehto J, Homan K Relation of blood pressure, serum lipids, and smoking to the risk of cerebral stroke: a longitudinal study in eastern Finland. Stroke 1982; 13: 327-333
79. Gordon T, Kannel WB, Castelli WP, Dawber TR Lipoproteins, cardiovascular disease, and death: the Framingham Study. Arch Intern Med 1981; 141: 1128-1131
80. Rhoads GG, Feinleib M Serum triglyceride and risk of coronary heart disease, stroke, and total mortality in Japanese-American men. Arteriosclerosis 1983; 3: 316-322
81. Lapidus L, Bengtsson C, Lindquist O, Sigurdsson JA, Rybo E Triglycerides -- main lipid risk factor for cardiovascular disease in women? Acta Med Scand 1985; 217: 481-489
82. Tell GS, Crouse JR, Furberg CD Relation between blood lipids, lipoproteins, and cerebrovascular atherosclerosis: a review. Stroke 1988; 19: 423-430
83. Atkins D, Psaty BM, Koepsell TD, Longstreth WT Jr, Larson EB Cholesterol reduction and the risk for stroke in men: a meta-analysis of randomized, controlled trials. Ann Intern Med 1993; 119: 136-145
84. Camargo CA Jr Moderate alcohol consumption and stroke: the epidemiologic evidence. Stroke 1989; 20: 1611-1626
85. Moore RD, Pearson TA Moderate alcohol consumption and coronary artery disease: a review. Medicine (Baltimore) 1986; 65: 242-267
86. Camargo CA Jr, Williams PT, Vranizan KM, Albers JJ, Wood PD The effect of moderate alcohol intake on serum apolipoproteins A-I and A-II: a controlled study. JAMA 1985; 253: 2854-2857
87. Jakubowski JA, Vaillancourt R, Deykin D Interaction of ethanol, prostacyclin, and aspirin in determining human platelet reactivity in vitro. Arteriosclerosis 1988; 8: 436-441
88. Thornton JR Atrial fibrillation in healthy non-alcoholic people after an alcoholic binge. Lancet 1984; 2: 1013-1015
89. MacMahon S Alcohol consumption and hypertension. Hypertension 1987; 9: 111-121
90. Mathew RJ, Wilson WH Regional cerebral blood flow changes associated with ethanol intoxication. Stroke 1986; 17: 1156-1159
91. Hillbom M, Kangasaho M, Kaste M, Numminen H, Vapaatalo H Acute ethanol ingestion increases platelet reactivity: is there a relationship to stroke? Stroke 1985; 16: 19-23
92. National Institute on Alcohol Abuse and Alcoholism. Sixth special report to the U.S. Congress on alcohol and health from the Secretary of Health and Human Services. Washington, D.C.: Government Printing Office, 1987. (DHHS publication no. (ADM) 87-1519.)
93. Williams GD, Grant BF, Stinson FS, Zobeck TS, Aitken SS, Nobel J Trends in alcohol-related morbidity and mortality. Public Health Rep 1988; 103: 592-597
94. Kris-Etherton PM, Krummel D, Russell ME, The effect of diet on plasma lipids, lipoproteins, and coronary heart disease. J Am Diet Assoc 1988; 88: 1373-1400
95. McGee D, Reed D, Stemmerman G, Rhoads G, Yano K, Feinleib M The relationship of dietary fat and cholesterol to mortality in 10 years: the Honolulu Heart Program. Int J Epidemiol 1985; 14: 97-105
96. Lapidus L, Andersson H, Bengtsson C, Bosaeus I Dietary habits in relation to incidence of cardiovascular disease and death in women: a 12-year follow-up of participants in the population study of women in Gothenburg, Sweden. Am J Clin Nutr 1986; 44: 444-448
97. Morris MC, Manson JE, Rosner B, Buring JE, Willett WC, Hennekens CH Fish consumption and cardiovascular disease in the Physicians' Health Study: a prospective study. Am J Epidemiol 1995; 142: 166-175
98. Keli SO, Feskens JM, Kromhout D Fish consumption and risk of stroke: the Zutphen Study. Stroke 1994; 25: 328-332
99. Hirai A, Terano T, Saito H, Tamura Y, Yoshida S. Clinical and epidemiological studies of eicosapentaenoic acid in Japan. In: Lands WEM, ed. Polyunsaturated fatty acids and eicosanoids. Champaign, Ill.: American Oil Chemists' Society, 1987:9-24.
100. Leaf A, Weber PC Cardiovascular effects of n-3 fatty acids. N Engl J Med 1988; 318: 549-557
101. Steinberg D, Parthasarathy S, Carew TE, Khoo JC, Witztum JL Beyond cholesterol: modifications of low-density lipoprotein that increase its atherogenicity. N Engl J Med 1989; 320: 915-924
102. Beckman JS, Beckman TW, Chen J, Marshall PA, Freeman BA Apparent hydroxyl radical production by peroxynitrite: implications for endothelial injury from nitric oxide and superoxide. Proc Natl Acad Sci U S A 1990; 87: 1620-1624
103. Marcus AJ, Silk ST, Safier LB, Ullman HL Superoxide production and reducing activity in human platelets. J Clin Invest 1977; 59: 149-158
104. Saran M, Michel C, Bors W Reaction of NO with O2-: implications for the action of endothelium-derived relaxing factor (EDRF). Free Radic Res 1990; 10: 221-226
105. Gaziano JM, Manson JE, Ridker PM, Buring JE, Hennekens CH Beta carotene therapy for chronic stable angina. Circulation 1990; 82: Suppl III: III-201 abstract.
106. Blot WJ, Li JY, Taylor PR, Nutrition intervention trials in Linxian, china: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. J Natl Cancer Inst 1993; 85: 1483-1492
107. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994; 330: 1029-1035
108. Manson JE, Stampfer MJ, Willett WC, Antioxidant vitamin consumption and incidence of stroke in women. Circulation 1993; 87: Suppl: 1-1 abstract.
109. Gey KF, Stahelin HB, Eichholzer M Poor plasma status of carotene and vitamin C is associated with higher mortality from ischemic heart disease and stroke: Basel Prospective Study. Clin Investig 1993; 71: 3-6
110. Kok FJ, de Bruijn AM, Vermeeren R, Serum selenium, vitamin antioxidants, and cardiovascular mortality: a 9-year follow-up study in the Netherlands. Am J Clin Nutr 1987; 45: 462-468
111. Gillman MW, Cupples LA, Gagnon D, Protective effect of fruits and vegetables on development of stroke in men. JAMA 1995; 273: 1113-1117
112. Steering Committee of the Physicians' Health Study Research Group. Final report on the aspirin component of the ongoing Physicians' Health Study. N Engl J Med 1989; 321: 129-135
113. Women's Health Study Research Group. The Women's Health Study: rationale and background. J Myocard Ischemia 1992; 4: 30-40
114. Antiplatelet Trialists' Collaboration. Collaborative overview of randomised trials of antiplatelet therapy. I. Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. BMJ 1994; 308: 81-106 [Erratum, BMJ 1994;308:1540.]
115. Barnett HJM, Eliasziw M, Meldrum HE Drugs and surgery in the prevention of ischemic stroke. N Engl J Med 1995; 332: 238-248
116. Peto R, Gray R, Collins R, Randomised trial of prophylactic daily aspirin in British male doctors. BMJ 1988; 296: 313-316
117. Manson JE, Stampfer MJ, Colditz GA, A prospective study of aspirin use and primary prevention of cardiovascular disease in women. JAMA 1991; 266: 521-527
118. Paganini-Hill A, Chao A, Ross RK, Henderson BE Aspirin use and chronic diseases: a cohort study of the elderly. BMJ 1989; 299: 1247-1250
119. van Gijn J Aspirin: dose and indications in modern stroke prevention. Neurol Clin 1992; 10: 193-207
120. Spranger M, Aspey BS, Harrison MJG Sex difference in antithrombotic effect of aspirin. Stroke 1989; 20: 34-37
121. Realini JP, Goldzieher JW Oral contraceptives and cardiovascular disease: a critique of the epidemiologic studies. Am J Obstet Gynecol 1985; 152: 729-798
122. Dalen JE, Hickler RB Oral contraceptives and cardiovascular disease. Am Heart J 1981; 101: 626-639
123. Stadel BV Oral contraceptives and cardiovascular disease. N Engl J Med 1981; 305: 672-677
124. Longstreth WT Jr, Swanson PD Oral contraceptives and stroke. Stroke 1984; 15: 747-750
125. Inman WHW, Vessey MP, Westerhom B, Engelund A Thromboembolic disease and the steroidal content of oral contraceptives: a report to the Committee on Safety of Drugs. BMJ 1970; 2: 203-209
126. Meade TW Effects of progestogens on the cardiovascular system. Am J Obstet Gynecol 1982; 142: 776-780
127. Katerndahl DA, Realini JP, Cohen PA Oral contraceptive use and cardiovascular disease: is the relationship real or due to study bias? J Fam Pract 1992; 35: 147-157
128. Porter JB, Hunter JR, Jick H, Stergachis A Oral contraceptives and nonfatal vascular disease. Obstet Gynecol 1985; 66: 1-4
129. Stampfer MJ, Willett WC, Colditz GA, Speizer FE, Hennekens CH A prospective study of past use of oral contraceptive agents and risk of cardiovascular diseases. N Engl J Med 1988; 319: 1313-1317
130. Vessey MP, Lawless M, Yeates D Oral contraceptives and stroke: findings in a large prospective study. BMJ 1984; 289: 530-531
131. Thorogood M, Mann J, Murphy M, Vessey M Fatal stroke and use of oral contraceptives: findings from a case-control study. Am J Epidemiol 1992; 136: 35-45
132. Hannaford PC, Croft PR, Kay CR Oral contraception and stroke: evidence from the Royal College of General Practitioners' Oral Contraception Study. Stroke 1994; 25: 935-942
133. Lobo RA Estrogen and cardiovascular disease. Ann N Y Acad Sci 1990; 592: 286-294
134. Fischer GM, Cherian K, Swain ML Increased synthesis of aortic collagen and elastin in experimental atherosclerosis: inhibition by contraceptive steroids. Atherosclerosis 1981; 39: 463-467
135. Chang W-C, Nakao J, Orimo H, Murota S-I Stimulation of prostaglandin cyclooxygenase and prostacyclin synthetase activities by estradiol in rat aortic smooth muscle cells. Biochim Biophys Acta 1980; 620: 472-482
136. Grady D, Rubin SM, Petitti DB, Hormone therapy to prevent disease and prolong life in postmenopausal women. Ann Intern Med 1992; 117: 1016-1037
137. Finucane FF, Madans JH, Bush TL, Wolf PH, Kleinman JC Decreased risk of stroke among postmenopausal hormone users: results from a national cohort. Arch Intern Med 1993; 153: 73-79
138. Cotton P Women's Health Initiative leads way as research begins to fill gender gaps. JAMA 1992; 267: 469-470
139. Department of Health and Human Services. Reducing the health consequences of smoking: 25 years of progress: a report of the Surgeon General: executive summary. Washington, D.C.: Government Printing Office, 1989. (DHHS publication no. (CDC) 89-8411.)
140. Dwyer JT. Treatment of obesity: conventional programs and fad diets. In: Bjorntorp P, Brodoff BN, eds. Obesity. Philadelphia: J.B. Lippincott, 1992:662-76.
141. Bjorntorp P. Physical exercise in the treatment of obesity. In: Bjorntorp P, Brodoff BN, eds. Obesity. Philadelphia: J.B. Lippincott, 1992:708-11.
142. McGinnis JM, Lee PR Healthy People 2000 at mid decade. JAMA 1995; 273: 1123-1129