Hormone replacement therapy is associated with improved survival in women with advanced heart failure.
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.
Lindenfeld
JoAnn
J
University of Colorado Health Sciences Center, Denver, Colorado 80262, USA. Lindenfeld@UCHSC.edu
Ghali
Jalal K
JK
Krause-Steinrauf
Heidi J
HJ
Khan
Steven
S
Adams
Kirkwood
K
Goldman
Steven
S
Peberdy
Mary Ann
MA
Yancy
Clyde
C
Thaneemit-Chen
Surai
S
Larsen
Rhonda L
RL
Young
James
J
Lowes
Brian
B
Rosenberg
Yves D
YD
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
D011412:Propanolamines; C024307:bucindolol