Hormone replacement therapy in Germany: determinants and possible health-related outcomes. Results of National Health Surveys from 1984 to 1999.
OBJECTIVE
To explore the determinants of hormone replacement therapy (HRT) use and possible health-related outcomes in Germany.


METHODS
827 current HRT users (age range 31-78 years, who had taken HRT products in the last 7 days before the medical interview) and 2371 age-matched nonusers were identified from five population-representative National Health Surveys performed from 1984 to 1999 in Germany. Cross-sectional comparisons between HRT users and nonusers were performed for socioeconomic factors and possible health-related outcomes. Regression models were used to obtain odds ratios of HRT use.


RESULTS
HRT use increased dramatically from 3% in 1984/1985 to 21% in 1998/1999 among German women aged 40-69. Regression analysis and comparison between HRT users and nonusers suggested that HRT use was closely associated with socioeconomic factors and personal lifestyle that may favor better health. In HRT users, however, we did not observe any health-related benefits in satisfaction with life or health. While HRT users appeared superior to nonusers with respect to the glycemic status, histories of cardiovascular diseases, despite a favorable lipid profile, occurred not less than in the group of nonusers.


CONCLUSIONS
In the settings of our cross-sectional studies in Germany HRT did not improve users' health benefits and did not show cardioprotective effects. The better glycemic status should be balanced against the higher risks of cardiovascular diseases and breast cancer.
Du
Yong
Y
RKI 22, Pharmacoepidemiology, Robert Koch-Institute, Seestr. 10, D-13353 Berlin, Germany.
Melchert
Hans-Ulrich
HU
Schäfer-Korting
Monika
M
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D005858:Germany; D006304:Health Status; D020249:Hormone Replacement Therapy / Q000706:statistics & numerical data*; D006801:Humans; D008019:Life Style; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D012907:Smoking; D012923:Social Class; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D008055:Lipids