Menopausal hormone therapy was associated with a significantly higher risk of incident cardiovascular disease compared to no hormone therapy in women veterans (HR 1.74; 95% CI 1.63-1.85; P<0.001).
Cohort (n=241,943)
Yes
Does menopausal hormone therapy increase the risk of incident cardiovascular disease in women veterans aged 45 years and older?
Menopausal hormone therapy is associated with a significantly increased risk of incident cardiovascular disease and all-cause mortality in women veterans aged 45 and older.
Effect estimate: HR 1.74 (95% CI 1.63-1.85)
Absolute Event Rate: 22.4% vs 11.7%
p-value: p=<0.001
AIMS: The impact of menopausal hormone therapy (HT), and its timing on cardiovascular disease (CVD) remains controversial in women. The aim of the study is to examine the association of HT with incident CVD in women veterans (WV). METHODS AND RESULTS: Veterans Health Administration (VHA) electronic records were used to identify WV aged ≥45 years who engaged with VHA from 1/1/2000-12/31/2017. HT was defined as any oral or transdermal oestrogen-containing product or combined oestrogen-progestin. Incident CVD was defined as new-onset ischaemic heart disease (IHD), stroke, heart failure (HF), atrial fibrillation/flutter (AF), aortic stenosis (AS), pulmonary hypertension (PHTN), venous thromboembolism (VTE), and peripheral arterial disease (PAD). Propensity score matching was used to match WV with and without HT on demographics, CVD risk factors, mental health conditions, and cardiovascular medication use. Cox proportional hazards models were used to estimate hazard ratios. Stratified analyses were conducted across distinct age categories. A total of 241 943 WV met the inclusion criteria, including 9295 with HT. After 1:2 propensity score matching, the HT cohort had significantly higher rates of CVD compared to the non-HT cohort (22.4% vs. 11.7%, P < 0.001), and all-cause mortality (8.0% vs. 5.2%, P < 0.001). In the Cox proportional hazards regression model, HT was independently associated with a greater risk of CVD (HR = 1.74, 95% CI: 1.63-1.85), Death (HR = 1.25 95% CI: 1.13-1.39), and IHD, stroke, HF, AF, AS, PHTN, PAD, and VTE. CONCLUSION: Our results suggest that menopausal HT is associated with increased risk of a broad range of CVD and death in WV 45 years and older.
Xu et al. (Wed,) conducted a cohort in Incident cardiovascular disease (n=241,943). Menopausal hormone therapy vs. No hormone therapy was evaluated on Incident cardiovascular disease (HR 1.74, 95% CI 1.63-1.85, p=<0.001). Menopausal hormone therapy was associated with a significantly higher risk of incident cardiovascular disease compared to no hormone therapy in women veterans (HR 1.74; 95% CI 1.63-1.85; P<0.001).