Prevention & lipidsCohort study
Hormone Replacement Therapy and Cardiovascular Outcomes by Race and Ethnicity
- prospective epidemiologic study
Authors' conclusion
We found relative benefit with early initiation of HRT in all race/ethnic groups except Chinese, adding to the complex literature on HRT use in CVD primary prevention. However, Chinese women with the metabolic syndrome or elevated triglycerides may have increased risk of adverse cardiovascular outcomes with HRT, suggesting further research is needed on racial and metabolic differences in the cardiovascular impact of HRT use.
Study context
- Population
- Postmenopausal women without cardiovascular disease (CVD) at enrollment in the Multi-Ethnic Study of Atherosclerosis (White, Black, Hispanic, and Chinese)postmenopausal women with data on hormone replacement therapy (HRT) and outcomes, followed up for a median of 14 years
- Participants
- 2,427 women
- Exposure
- timing of HRT initiation and differences by race/ethnicity
Main finding
MACE · median of 14 years
Hazard ratio
0.72
95% CI 0.55–0.96
As reported in the abstract
Observational data: associations, not effects.
Further findings
All-cause mortality · median of 14 years
| Comparison | HR (95% CI) | |
|---|---|---|
| HRT use within 5 years of menopause · decreased all-cause mortality | 0.62 (0.48–0.80) | |
| 0.512Hazard ratio (log scale) |
MACE and mortality in Chinese participants (subgroup)
| Comparison | HR (95% CI) | |
|---|---|---|
| Chinese participants on HRT · increased MACE | 2.27 (1.06–4.87) | |
| Chinese participants on HRT · trend towards increased mortality | 1.34 (0.73–2.47) | |
| 0.20.5125Hazard ratio (log scale) |
MACE and mortality in Chinese participants (subgroup)
- These findings were only seen in Chinese participants who had the metabolic syndrome or elevated triglyceride levels
Original publication
Summarised from the published abstract; every number is checked against it