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Hormone replacement therapy and the risk of incident congestive heart failure: the Cardiovascular Health Study.
J Womens Health (Larchmt) 2003; 12(4):341-50JW

Abstract

BACKGROUND

The development of congestive heart failure (CHF) in older persons is related to a variety of mechanisms. Hormone replacement therapy (HRT) affects several of the pathways that may be important in the development of CHF. We hypothesized that HRT would be associated with a decreased risk of incident CHF.

METHODS

Using Cox proportional-hazards regression, we assessed the risk of incident CHF (n = 304) associated with time-dependent past and current use of HRT compared to never use. The Cardiovascular Health Study is a prospective cohort study of community-dwelling adults aged 65 years and older. This analysis included female participants without a history of CHF at baseline (n = 3223).

RESULTS

At baseline, 62% were never users, 26% were past users, and 12% were current users of HRT. Compared with never users, the multivariable relative risk (RR) of CHF was 1.01 (95% confidence interval [95% CI] 0.76,1.34) for past users and 1.34 (0.93,1.94) for current users. Results were similar among most treatment and clinical subgroups, except that the association of current HRT with CHF appeared to depend on body mass index (BMI) or osteoporosis status. The RR was 0.82 (0.43,1.60) for normal weight women, 1.65 (0.95,2.88) for overweight women, and 2.22 (1.06,4.67) for obese women (p = 0.01 for interaction). Similarly, the RR was 0.15 (0.04,0.65) for women with osteoporosis and 1.82 (1.25,2.65) for women without osteoporosis (p = 0.001 for interaction).

CONCLUSIONS

Overall, HRT was not associated with the risk of incident CHF, although BMI and osteoporosis appeared to modify the association of HRT with CHF. The risk of CHF was lower in patients with lower BMI or osteoporosis.

Authors+Show Affiliations

Cardiovascular Health Research Unit, University of Washington, Metropolitan Park, East Tower, 1730 Minor Avenue, Seattle, WA 98101, USA. rea123@u.washington.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12804341

Citation

Rea, Thomas D., et al. "Hormone Replacement Therapy and the Risk of Incident Congestive Heart Failure: the Cardiovascular Health Study." Journal of Women's Health (2002), vol. 12, no. 4, 2003, pp. 341-50.
Rea TD, Psaty BM, Heckbert SR, et al. Hormone replacement therapy and the risk of incident congestive heart failure: the Cardiovascular Health Study. J Womens Health (Larchmt). 2003;12(4):341-50.
Rea, T. D., Psaty, B. M., Heckbert, S. R., Cushman, M., Meilahn, E., Olson, J. L., ... Chaves, P. H. (2003). Hormone replacement therapy and the risk of incident congestive heart failure: the Cardiovascular Health Study. Journal of Women's Health (2002), 12(4), pp. 341-50.
Rea TD, et al. Hormone Replacement Therapy and the Risk of Incident Congestive Heart Failure: the Cardiovascular Health Study. J Womens Health (Larchmt). 2003;12(4):341-50. PubMed PMID: 12804341.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hormone replacement therapy and the risk of incident congestive heart failure: the Cardiovascular Health Study. AU - Rea,Thomas D, AU - Psaty,Bruce M, AU - Heckbert,Susan R, AU - Cushman,Mary, AU - Meilahn,Elaine, AU - Olson,Jean L, AU - Lemaitre,Rozenn N, AU - Smith,Nicholas L, AU - Sotoodehnia,Nona, AU - Chaves,Paulo H M, PY - 2003/6/14/pubmed PY - 2003/9/5/medline PY - 2003/6/14/entrez SP - 341 EP - 50 JF - Journal of women's health (2002) JO - J Womens Health (Larchmt) VL - 12 IS - 4 N2 - BACKGROUND: The development of congestive heart failure (CHF) in older persons is related to a variety of mechanisms. Hormone replacement therapy (HRT) affects several of the pathways that may be important in the development of CHF. We hypothesized that HRT would be associated with a decreased risk of incident CHF. METHODS: Using Cox proportional-hazards regression, we assessed the risk of incident CHF (n = 304) associated with time-dependent past and current use of HRT compared to never use. The Cardiovascular Health Study is a prospective cohort study of community-dwelling adults aged 65 years and older. This analysis included female participants without a history of CHF at baseline (n = 3223). RESULTS: At baseline, 62% were never users, 26% were past users, and 12% were current users of HRT. Compared with never users, the multivariable relative risk (RR) of CHF was 1.01 (95% confidence interval [95% CI] 0.76,1.34) for past users and 1.34 (0.93,1.94) for current users. Results were similar among most treatment and clinical subgroups, except that the association of current HRT with CHF appeared to depend on body mass index (BMI) or osteoporosis status. The RR was 0.82 (0.43,1.60) for normal weight women, 1.65 (0.95,2.88) for overweight women, and 2.22 (1.06,4.67) for obese women (p = 0.01 for interaction). Similarly, the RR was 0.15 (0.04,0.65) for women with osteoporosis and 1.82 (1.25,2.65) for women without osteoporosis (p = 0.001 for interaction). CONCLUSIONS: Overall, HRT was not associated with the risk of incident CHF, although BMI and osteoporosis appeared to modify the association of HRT with CHF. The risk of CHF was lower in patients with lower BMI or osteoporosis. SN - 1540-9996 UR - https://www.unboundmedicine.com/medline/citation/12804341/Hormone_replacement_therapy_and_the_risk_of_incident_congestive_heart_failure:_the_Cardiovascular_Health_Study_ L2 - https://www.liebertpub.com/doi/full/10.1089/154099903765448853?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -