Socioeconomic position and hormone replacement therapy use: explaining the discrepancy in evidence from observational and randomized controlled trials.
OBJECTIVE
We assessed the association between life-course socioeconomic status or position (SEP) and hormone replacement therapy (HRT).


METHODS
We conducted a cross-sectional analysis of 4286 women aged 60 to 79 years.


RESULTS
Women experiencing adverse socioeconomic circumstances across the life course were less likely to have used HRT. The associations of childhood socioeconomic measures with HRT use were independent of adult SEP, behavioral risk factors, and physiological risk factors for heart disease.


CONCLUSIONS
SEP from across the life course is associated with HRT use. Because the association between early life SEP and HRT is not fully explained by adult risk factors, residual confounding (which is not captured by adjustment for adult variables only) may explain some of the disparity between observational studies and randomized controlled trials in this area.
Lawlor
Debbie A
DA
Department of Social Medicine, University of Bristol, Bristol BS7 8QA, UK. d.a.lawlor@bristol.ac.uk
Smith
George Davey
GD
Ebrahim
Shah
S
D000368:Aged; D003327:Coronary Disease / Q000517:prevention & control; D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008875:Middle Aged; D019370:Observation; D016032:Randomized Controlled Trials as Topic; D012923:Social Class; D012959:Socioeconomic Factors; D006113:United Kingdom