Effect of lifestyle factors and hormone therapy on heart function by serial echocardiography in postmenopausal women.
BACKGROUND
There is conflicting information on the effects of oestrogen on the heart in women, especially those using postmenopausal hormone therapy. Whilst some studies reported a beneficial effect, others showed adverse outcomes. The interplay of lifestyle factors and type/timing of therapy remains to be clarified.


OBJECTIVE
The aim of this study was to determine the effects of lifestyle and hormone therapy on heart function and structure in postmenopausal women.


METHODS
As part of a large longitudinal study of women randomly recruited from an urban population, the study assessed 410 suitable women by echocardiography in Year 1 and Year 5 of the study by two independent cardiologists.


RESULTS
In lifestyle characteristics, the difference in age and body mass (as markers of cardiovascular risk) was in favour of never-users versus hormone therapy-users. Using an arbitrary cut-off > or =15% change for an effect, we found lifestyle factors had minimal effect on the two measured parameters - ejection fraction, left ventricular mass. Effects of hormone therapy were variable and mixed; greatest effect was found for an 'early start' of hormone therapy with oestrogen-only preparation - the risk of reduced ejection fraction was decreased [hazard ratio (HR) 0.42, confidence interval = 0.17-1.03, P = 0.06] and risk of increased left ventricular mass was increased (HR 2.21, 1.09-4.49, P = 0.03).


CONCLUSIONS
Our findings add to the evidence that oestrogen given to postmenopausal women has a mixed effect on the heart, with effect best shown when started early.
Khoo
Soo-Keat
SK
Betty Byrne Henderson Women's Health Research Centre, University of Queensland and Royal Brisbane and Women's Hospital, Australia. s.khoo@ug.edu.au
O'Neill
Sheila
S
Scalia
Gregory
G
Tripcony
Lee
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D015992:Body Mass Index; D004452:Echocardiography; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008875:Middle Aged; D017698:Postmenopause / Q000187:drug effects / Q000502:physiology*; D012907:Smoking; D013318:Stroke Volume / Q000187:drug effects*; D020257:Ventricular Remodeling / Q000187:drug effects*