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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Dr Mosca,¹ in her comprehensive review of the literature on the role of hormone replacement therapy (HRT) in the prevention of postmenopausal heart disease, falls into a trap that is all too common: she attributes causality to associations found in observational studies. Consider the following quotes from her article that appear in the "Observational Studies" subsection of the "ERT [estrogen replacement therapy]/HRT and CHD [coronary heart disease] Events" section:

• "These studies have consistently shown a reduction in the incidence of CHD and in the overall mortality of postmenopausal women using ERT/HRT."
  
• ". . . a 16-year follow-up of the Nurses' Health Study . . . reported similar beneficial effects."
  
• "A similar beneficial effect . . . was observed . . . in the Iowa Women's Health Study."
  
• ". . . [estrogen] . . . reduced the incidence of a first MI [myocardial infarction] by 31% . . . ."
  
• "Meta-analyses . . . [Full Text of this Article]