Hormone replacement therapy and asthma onset in menopausal women: National cohort study - 05/05/21
, Holly Tibble, MSc a, Rebecca Pillinger, PhD a, Susannah McLean, MD a, Dermot Ryan, MD a, b, Hilary Critchley, MD c, David Price, MD b, d, e, Catherine M. Hawrylowicz, PhD f, Colin R. Simpson, PhD a, g, Ireneous N. Soyiri, PhD a, h, Francis Appiagyei, MSc b, Aziz Sheikh, MD a, Bright I. Nwaru, PhD a, i, jAbstract |
Background |
There is uncertainty about the role of hormonal replacement therapy (HRT) in the development of asthma.
Objective |
We investigated whether use of HRT and duration of use was associated with risk of development of asthma in perimenopausal and postmenopausal women.
Methods |
We constructed a 17-year (from January 1, 2000, to December 31, 2016) open cohort of 353,173 women (aged 46-70 years) from the Optimum Patient Care Database, a longitudinal primary care database from across the United Kingdom. HRT use, subtypes, and duration of use; confounding variables; and asthma onset were defined by using the Read Clinical Classification System. We fitted multilevel Cox regression models to estimate hazard ratios (HRs) with 95% CIs.
Results |
During the 17-year follow-up (1,340,423 person years), 7,614 new asthma cases occurred, giving an incidence rate of 5.7 (95% CI = 5.5-5.8) per 1,000 person years. Compared with nonuse of HRT, previous use of any (HR = 0.83; 95% CI = 0.76-0.88), estrogen-only (HR = 0.89; 95% CI = 0.84-0.95), or combined estrogen and progestogen (HR = 0.82; 95% CI = 0.76-0.88) HRT was associated with a reduced risk of asthma onset. This was also the case with current use of any (HR = 0.79; 95% CI = 0.74-0.85), estrogen-only (HR = 0.80; 95% CI = 0.73-0.87), and combined estrogen and progestogen (HR = 0.78; 95% CI = 0.70-0.87) HRT. Longer duration of HRT use (1-2 years [HR = 0.93; 95% CI = 0.87-0.99]; 3-4 years [HR = 0.77; 95% CI = 0.70-0.84]; and ≥5 years [HR = 0.71; 95% CI = 0.64-0.78]) was associated with a dose-response reduced risk of asthma onset.
Conclusion |
We found that HRT was associated with a reduced risk of development of late onset asthma in menopausal women. Further cohort studies are needed to confirm these findings.
Le texte complet de cet article est disponible en PDF.Key words : Asthma, estrogens, epidemiology, estradiol, progestogen
Abbreviations used : BMI, ER, GP, HRT, IMD, OPCRD, QOF
Plan
| Supported by Asthma UK (grant AUK-IG-2016-346) and Health Data Research UK. B.N. acknowledges support of the Knut and Alice Wallenberg Foundation; the Wallenberg Centre for Molecular and Translational Medicine, OPC, OPRI, University of Gothenburg, Sweden; and the VBG Group Herman Krefting Foundation on Asthma and Allergy. The funders (Asthma UK and Health Data Research UK) had no influence on the design of the study, the interpretation of its findings, or the decision to publish. |
|
| Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest. |
Vol 147 - N° 5
P. 1662-1670 - mai 2021 Retour au numéro
Article précédent
- IL-6–based mortality prediction model for COVID-19: Validation and update in multicenter and second wave cohorts
- Alberto Utrero-Rico, Javier Ruiz-Hornillos, Cecilia González-Cuadrado, Claudia Geraldine Rita, Berta Almoguera, Pablo Minguez, Antonio Herrero-González, Mario Fernández-Ruiz, Octavio Carretero, Juan Carlos Taracido-Fernández, Rosario López-Rodriguez, Marta Corton, José María Aguado, Luisa María Villar, Carmen Ayuso-García, Estela Paz-Artal, Rocio Laguna-Goya
- Predominant DNMT and TET mediate effects of allergen on the human bronchial epithelium in a controlled air pollution exposure study
- Hang Li, Min Hyung Ryu, Christopher F. Rider, Wayne Tse, Rachel L. Clifford, Maria J. Aristizabal, Weiping Wen, Chris Carlsten
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?