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Hormone replacement therapy and the risk of incident congestive heart failure: the Cardiovascular Health Study

Thomas D Rea1, Bruce M Psaty, Susan R Heckbert

  • 1Cardiovascular Health Research Unit, University of Washington, Metropolitan Park, East Tower, 1730 Minor Avenue, Seattle, WA 98101, USA. rea123@u.washington.edu

Journal of Women'S Health (2002)
|June 14, 2003
PubMed

Insights

Hormone replacement therapy (HRT) did not significantly alter the risk of congestive heart failure (CHF) in older women. However, body mass index and osteoporosis status influenced this association, with lower BMI or osteoporosis linked to reduced CHF risk.

Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Endocrinology

Background:

  • Congestive heart failure (CHF) development in older adults involves complex mechanisms.
  • Hormone replacement therapy (HRT) influences pathways relevant to CHF pathogenesis.
  • Previous research suggests a potential link between HRT and cardiovascular health.

Purpose of the Study:

  • To investigate the association between hormone replacement therapy (HRT) use and the risk of incident congestive heart failure (CHF) in older women.
  • To determine if HRT use modifies CHF risk in elderly women.
  • To explore potential modifying factors in the HRT-CHF relationship.

Main Methods:

  • Prospective cohort study (Cardiovascular Health Study) including 3223 women aged 65+ without baseline CHF.
  • Cox proportional-hazards regression used to assess time-dependent HRT use (past, current, never) and incident CHF risk.
  • Analysis adjusted for relevant covariates and explored interactions with BMI and osteoporosis.

Main Results:

  • Overall, HRT was not associated with a significantly increased or decreased risk of incident CHF.
  • Current HRT users showed a relative risk (RR) of 1.34 (95% CI 0.93, 1.94) compared to never users.
  • The association between HRT and CHF risk was significantly modified by Body Mass Index (BMI) and osteoporosis status.

Conclusions:

  • Hormone replacement therapy (HRT) is not generally associated with the risk of developing congestive heart failure (CHF) in older women.
  • Body Mass Index (BMI) and osteoporosis status are significant modifiers of the HRT-CHF association.
  • Lower BMI and the presence of osteoporosis were associated with a reduced risk of CHF in the context of HRT use.
Abstract

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