Menopause, postmenopausal estrogen preparations, and the risk of adult-onset asthma. A prospective cohort study.
We prospectively evaluated the association of hormone replacement therapy and asthma incidence in a cohort of pre- and postmenopausal women 34 to 68 yr of age. During 582, 135 person-years of follow-up between 1980 and 1990, 726 new cases of asthma were documented. Postmenopausal women who were never users of replacement hormones had a significantly lower age-adjusted risk of asthma than premenopausal women (relative risk = 0.65; 95% confidence interval [CI] = 0.46 to 0.92). Among naturally menopausal women, the age-adjusted relative risk of asthma for ever use of postmenopausal hormones was 1.49 (95% CI = 1.10 to 2.00); for current use of hormones (conjugated estrogens with or without progesterone), 1.50 (95% CI = 0.98 to 2.30); and for past use, 1.52 (95% CI = 1.08 to 2.13), compared with never use of hormones. Ever users of 10 or more years' duration had twice the age-adjusted risk of asthma compared with women who never used postmenopausal hormones (95% CI = 1.39 to 2.87). Among current users of conjugated estrogens, there was a positive dose-response demonstrated between daily dose and asthma risk (p for trend = 0.007). While confirmatory studies are warranted, these data suggest that estrogen plays a role in the pathophysiology of asthma and that long-term use and/or high doses of postmenopausal hormone therapy increase subsequent risk of asthma.
Troisi
R J
RJ
Channing Laboratory, Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA.
Speizer
F E
FE
Willett
W C
WC
Trichopoulos
D
D
Rosner
B
B
D000328:Adult; D000367:Age Factors; D001249:Asthma / Q000139:chemically induced* / Q000453:epidemiology* / Q000503:physiopathology; D015992:Body Mass Index; D016022:Case-Control Studies; D015331:Cohort Studies; D003276:Contraceptives, Oral; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D004967:Estrogens / Q000502:physiology; D004966:Estrogens, Conjugated (USP) / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D017698:Postmenopause / Q000502:physiology*; D011372:Progestins / Q000009:adverse effects*; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013997:Time Factors
D003276:Contraceptives, Oral; D004967:Estrogens; D004966:Estrogens, Conjugated (USP); D011372:Progestins