To the Editor: Dr Barrett-Connor and colleagues1 concluded that 4 years of postmenopausal raloxifene
therapy significantly reduces the risk of cardiovascular events in women who
are at increased risk. Several aspects of the authors' classification scheme,
however, limit the validity of their findings.
The criteria used to create a subset of women "with increased cardiovascular
risk"1 seem arbitrary and prone to incorrect
risk stratification. I believe that it is inappropriate, for instance, that
women with diabetes mellitus received as much as 75% of the points as did
women with prior myocardial infarction, especially given the nonstandard definitions
used to classify certain risk factors, such as diabetes, used in this study.
The rationale for the point system is not justified either in this study or
in the referenced article,2 which uses a
slightly different system.
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