A new study found that combined HRT was associated with a lower risk of all-cause mortality in healthy women

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A study published in BJOG found that combined hormone replacement therapy (HRT), but not oestrogen-only HRT, was associated with a lower risk of all-cause mortality in healthy women (aged 46–65 years) who were followed up for many years.

The findings strengthen the emerging consensus that the benefits of long-term HRT balance the harms for most women.

The retrospective matched cohort study included 105,199 HRT users (cases; age, 46–65 years) and 224,643 matched non-users of HRT (controls), identified using data from The Health Improvement Network database (1984–2017). The follow-up duration was 13.5 years per participant.

Key results

Among 105,199 HRT users, 17,606 (17%) received oestrogen-only therapy and 87,593 (83%) received combined HRT therapy.

Combined HRT (adjusted hazard ratio [aHR], 0.91; 95% confidence interval [CI], 0.88–0.94), but not oestrogen-only HRT (aHR, 0.99; 95% CI, 0.93–1.07), was associated with a lower risk of all-cause mortality.

Age-specific aHRs (95% CIs) for all-cause mortality in women who received combined HRT and oestrogen-only HRT as first treatment across different age groups were:

  • for combined HRT:
    • 0.98 (0.92–1.04) for age 46-50 years;
    • 0.87 (0.82–0.92) for age 51-55 years;
    • 0.88 (0.82–0.93) for age 56-60 years; and
    • 0.92 (0.85–0.98) for age 61-65 years.
  • for oestrogen-only HRT:
    • 1.01 (0.84–1.21) for age 46-50 years;
    • 1.03 (0.89–1.18) for age 51-55 years;
    • 0.98 (0.86–1.12) for age 56-60 years; and
    • 0.93 (0.81–1.07) for age 61-65 years.

Conclusions

Combined HRT was associated with a 9% lower risk of all-cause mortality; oestrogen-only formulation was not associated with any significant changes.

This article originally appeared on Univadis, part of the Medscape Professional Network.


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