Hormone replacement therapy and the risk of incident congestive heart failure: The cardiovascular health study

Thomas D. Rea, Bruce M. Psaty, Susan R. Heckbert, Mary Cushman, Elaine Meilahn, Jean L. Olson, Rozenn N. Lemaitre, Nicholas L. Smith, Nona Sotoodehnia, Paulo H M Chaves

Research output: Contribution to journalArticle

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 (BMD 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.

Original languageEnglish (US)
Pages (from-to)341-350
Number of pages10
JournalJournal of Women's Health
Volume12
Issue number4
StatePublished - May 2003

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Hormone Replacement Therapy
Heart Failure
Health
Osteoporosis
Independent Living
Body Mass Index
Cohort Studies
Prospective Studies
Confidence Intervals
Weights and Measures

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Rea, T. D., Psaty, B. M., Heckbert, S. R., Cushman, M., Meilahn, E., Olson, J. L., ... Chaves, P. H. M. (2003). Hormone replacement therapy and the risk of incident congestive heart failure: The cardiovascular health study. Journal of Women's Health, 12(4), 341-350.

Hormone replacement therapy and the risk of incident congestive heart failure : The cardiovascular health study. / Rea, Thomas D.; Psaty, Bruce M.; Heckbert, Susan R.; Cushman, Mary; Meilahn, Elaine; Olson, Jean L.; Lemaitre, Rozenn N.; Smith, Nicholas L.; Sotoodehnia, Nona; Chaves, Paulo H M.

In: Journal of Women's Health, Vol. 12, No. 4, 05.2003, p. 341-350.

Research output: Contribution to journalArticle

Rea, TD, Psaty, BM, Heckbert, SR, Cushman, M, Meilahn, E, Olson, JL, Lemaitre, RN, Smith, NL, Sotoodehnia, N & Chaves, PHM 2003, 'Hormone replacement therapy and the risk of incident congestive heart failure: The cardiovascular health study', Journal of Women's Health, vol. 12, no. 4, pp. 341-350.
Rea TD, Psaty BM, Heckbert SR, Cushman M, Meilahn E, Olson JL et al. Hormone replacement therapy and the risk of incident congestive heart failure: The cardiovascular health study. Journal of Women's Health. 2003 May;12(4):341-350.
Rea, Thomas D. ; Psaty, Bruce M. ; Heckbert, Susan R. ; Cushman, Mary ; Meilahn, Elaine ; Olson, Jean L. ; Lemaitre, Rozenn N. ; Smith, Nicholas L. ; Sotoodehnia, Nona ; Chaves, Paulo H M. / Hormone replacement therapy and the risk of incident congestive heart failure : The cardiovascular health study. In: Journal of Women's Health. 2003 ; Vol. 12, No. 4. pp. 341-350.
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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 (BMD 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.",
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T1 - Hormone replacement therapy and the risk of incident congestive heart failure

T2 - 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

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Y1 - 2003/5

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 (BMD 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.

AB - 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 (BMD 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.

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