title: Estradiol-based postmenopausal hormone therapy and risk of cardiovascular and all-cause mortality.
abstract: OBJECTIVE
  Data on the health benefits and risks of postmenopausal hormone therapy (HT) are derived mainly from the use of conjugated equine estrogens. Estradiol-based regimens may have a different risk-benefit profile. We evaluated the risk of death caused by coronary heart disease (CHD), stroke, or any disease among users of estradiol-based HT regimens in a nationwide study in Finland.
  
  
  METHODS
  A total of 489,105 women who used HT from 1994 to 2009 (3.3 million HT exposure years), as indicated in the nationwide reimbursement register and the national Cause of Death Register, were followed. A total of 28,734 HT users died during follow-up; among the deaths, 3,843 were caused by CHD and 2,464 were caused by stroke. Mortality risk in HT users with varying duration of exposure (≤1 y, >1 to 3 y, >3 to 5 y, >5 to 10 y, or >10 y) was compared with that in an age-matched background population.
  
  
  RESULTS
  Risk of CHD death was significantly reduced by 18% to 54% in HT users and was positively related to HT exposure time. Risk of stroke death was also reduced by 18% to 39%, but this reduction was not clearly related to HT exposure time. Risk of all-cause mortality was reduced in HT users by 12% to 38%, almost in linear relationship with duration of exposure. All these risk reductions were comparable in women initiating HT before age 60 years and women initiating HT at age 60 years or older.
  
  
  CONCLUSIONS
  In absolute terms, the risk reductions mean 19 fewer CHD deaths and 7 fewer stroke deaths per 1,000 women using any HT for at least 10 years.
authors: 1Department of Obstetrics and Gynecology, Helsinki University, Helsinki University Hospital, Helsinki, Finland 2Folkhälsan Research Center, Helsinki, Finland 3EPID Research Oy, Espoo, Finland 4National Institute for Health and Welfare, Helsinki, Finland 5Nordic School of Public Health, Gothenburg, Sweden.
authors: Tomi S
authors: TS
authors: Mikkola
authors: Pauliina
authors: P
authors: Tuomikoski
authors: Heli
authors: H
authors: Lyytinen
authors: Pasi
authors: P
authors: Korhonen
authors: Fabian
authors: F
authors: Hoti
authors: Pia
authors: P
authors: Vattulainen
authors: Mika
authors: M
authors: Gissler
authors: Olavi
authors: O
authors: Ylikorkala
mesh_terms: D000367:Age Factors; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D002423:Cause of Death; D004958:Estradiol / Q000008:administration & dosage*; D015914:Estrogen Replacement Therapy; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality*
chemical_list: D004958:Estradiol