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Menopausal hormone therapy and risk of cardiovascular events in women with prediabetes or type 2 diabetes: A pooled analysis of 2917 postmenopausal women.

TitleMenopausal hormone therapy and risk of cardiovascular events in women with prediabetes or type 2 diabetes: A pooled analysis of 2917 postmenopausal women.
Publication TypeJournal Article
Year of Publication2022
AuthorsYoshida Y, Chen Z, Baudier RL, Krousel-Wood M, Anderson AH, Fonseca VA, Mauvais-Jarvis F
JournalAtherosclerosis
Volume344
Pagination13-19
Date Published2022 03
ISSN1879-1484
KeywordsCardiovascular Diseases, Coronary Disease, Diabetes Mellitus, Type 2, Female, Humans, Menopause, Postmenopause, Prediabetic State, Prospective Studies, Risk Assessment, Risk Factors
Abstract

BACKGROUND AND AIMS: The effect of MHT on cardiovascular disease (CVD) risk among women with prediabetes or type 2 diabetes (PreDM or T2DM) is unclear. We examined the association between ever or early use MHT and CVD risk in postmenopausal women with PreDM or T2DM, and the potential modifying effect of race.

METHODS: 2,917 postmenopausal women with PreDM or T2DM were pooled from 3 prospective CVD cohorts (the Atherosclerosis Risk in Communities, the Multi-Ethnic Study of Atherosclerosis, and the Jackson Heart Study). Ever (yes vs no) or early use of MHT (MHT initiated ≤5 vs > 5 years since menopause), and their associations with ischemic stroke, coronary heart disease (CHD), and atherosclerotic cardiovascular disease (ASCVD) were assessed using Cox proportional hazards models.

RESULTS: During a median follow-up of 15 years, 264 stroke, 484 CHD, and 659 ASCVD events were observed. In fully adjusted models, ever use of MHT was associated with reduced risk of stroke (hazard ratio 0.86, 95% CI 0.76-0.98), CHD (0.85, 0.74-0.98), and ASCVD (0.83, 0.73-0.95) in white women with PreDM or T2DM. Early use of MHT was associated with reduced risk of stroke (0.82, 0.72-0.95), CHD (0.85, 0.74-0.98), and ASCVD (0.82, 0.70-0.96) in the white group. No risk reduction with ever or early use of MHT was found for black women with PreDM or T2DM.

CONCLUSIONS: MHT is associated with statistically reduced CVD risk among white but not black women with PreDM or DM. Race is an effect modifier in the association between MHT use and CVD.

DOI10.1016/j.atherosclerosis.2022.01.016
Alternate JournalAtherosclerosis
PubMed ID35114556
PubMed Central IDPMC8905583
Grant ListI01 BX003725 / BX / BLRD VA / United States
R01 DK074970 / DK / NIDDK NIH HHS / United States
K12 HD043451 / HD / NICHD NIH HHS / United States
P20 GM109036 / GM / NIGMS NIH HHS / United States
R01 DK107444 / DK / NIDDK NIH HHS / United States
R01 DK107566 / DK / NIDDK NIH HHS / United States
R01 DK104730 / DK / NIDDK NIH HHS / United States