title: Hormone replacement therapy is associated with improved survival in women with advanced heart failure.
abstract: OBJECTIVE
  We sought to determine whether hormone replacement therapy (HRT) is associated with an improved prognosis in women with advanced heart failure (HF) and systolic dysfunction.
  
  
  BACKGROUND
  There are about two million postmenopausal women in the U.S. with HF. However, limited data are available to assess the effects of HRT on survival in this large group of patients.
  
  
  METHODS
  A retrospective analysis of women age 50 years and over entered into the Beta-Blocker Evaluation of Survival Trial (BEST) was conducted using Cox regression analysis comparing survival in HRT users and non-users after correcting for baseline variables known to predict survival in women with HF and systolic dysfunction.
  
  
  RESULTS
  In 493 women age 50 years and older, HRT was associated with a significant reduction in mortality-21% mortality in HRT users and 34% in non-users (p = 0.025). Multivariate analysis demonstrated a hazard ratio for mortality of 0.6 (95% confidence interval = 0.36 to 0.97) (p = 0.039) for HRT users. The benefits of HRT were noted only in women with a nonischemic etiology of HF (n = 237).
  
  
  CONCLUSIONS
  Hormone replacement therapy is associated with a marked improvement in survival in postmenopausal women with advanced HF. A prospective, randomized trial of HRT should be performed in this large group of patients.
authors.affiliation: University of Colorado Health Sciences Center, Denver, Colorado 80262, USA. Lindenfeld@UCHSC.edu
authors.forename: JoAnn
authors.initials: J
authors.lastname: Lindenfeld
authors.forename: Jalal K
authors.initials: JK
authors.lastname: Ghali
authors.forename: Heidi J
authors.initials: HJ
authors.lastname: Krause-Steinrauf
authors.forename: Steven
authors.initials: S
authors.lastname: Khan
authors.forename: Kirkwood
authors.initials: K
authors.lastname: Adams
authors.forename: Steven
authors.initials: S
authors.lastname: Goldman
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Peberdy
authors.forename: Clyde
authors.initials: C
authors.lastname: Yancy
authors.forename: Surai
authors.initials: S
authors.lastname: Thaneemit-Chen
authors.forename: Rhonda L
authors.initials: RL
authors.lastname: Larsen
authors.forename: James
authors.initials: J
authors.lastname: Young
authors.forename: Brian
authors.initials: B
authors.lastname: Lowes
authors.forename: Yves D
authors.initials: YD
authors.lastname: Rosenberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001130:Arizona; D002140:California; D003120:Colorado; D015914:Estrogen Replacement Therapy; D005260:Female; D006333:Heart Failure / Q000401:mortality* / Q000517:prevention & control*; D006801:Humans; D008145:Louisiana; D008396:Maryland; D008875:Middle Aged; D009657:North Carolina; D009820:Ohio; D017698:Postmenopause; D011379:Prognosis; D011412:Propanolamines / Q000008:administration & dosage; D016016:Proportional Hazards Models; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D016019:Survival Analysis; D013599:Systole; D013781:Texas; D018487:Ventricular Dysfunction, Left; D014768:Virginia; D016387:Women's Health
chemical_list: D011412:Propanolamines; C024307:bucindolol