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Incidence of cardiovascular disease, cancer and death in postmenopausal women affirming use of hormone replacement therapy

Department of Community Medicine Lund University, Malmö, Sweden, Bo.Hedblad{at}smi.mas.lu.se, Department of Medicine, Lund University, Malmö University Hospital, Malmö, Sweden

Juan Merlo

Department of Community Medicine Lund University, Malmö, Sweden, NEPI Foundation, Malmö and Stockholm, Sweden

Jonas Manjer

Department of Community Medicine Lund University, Malmö, Sweden

Gunnar Engström

Department of Community Medicine Lund University, Malmö, Sweden

Göran Berglund

Department of Medicine, Lund University, Malmö University Hospital, Malmö, Sweden

Lars Janzon

Department of Community Medicine Lund University, Malmö, Sweden

Aim: The goal of this study was to evaluate the incidence of myocardial infarction, cancer and death in relation to use of hormone replacement therapy (HRT). Methods : Nine years' follow up of an urban cohort of peri-/postmenopausal women was undertaken. Local and national registers were used for retrieval of events. Results: The incidence of myocardial infarction per 1,000 person-years in users and non-users was 0.61 (5/962) and 2.20 (92/4759) respectively, adjusted relative risk (RR) 0.37; 95% confi dence interval 0.15-0.90. Rates of mortality from cardiovascular disease and cancer were 0.36 and 1.10, p= 0.058, and 2.60 and 2.09, p=0.360, respectively. In terms of all-cause mortality the adjusted RR was 1.02; 0.69- 1.52, incidence of cancer 1.28; 1.01-1.64, breast cancer 1.52; 1.01-2.28 and endometrial cancer 3.61; 1.54-8.46 . Conclusions: Women affirming use of HRT had a lower incidence of myocardial infarction. Further studies are needed to assess whether the absence of effect on total mortality may be accounted for by an increased cancer risk.

Key Words: cancer • cardiovascular • mortality • population • postmenopausal HRT.

Scandinavian Journal of Public Health, Vol. 30, No. 1, 12-19 (2002)
DOI: 10.1177/14034948020300010601


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