Association of hormone therapy with cardiovascular events in females using statins for prevention.

Abstract

Objective: The association of hormone therapy (HT) combined with statin use for primary prevention of cardiovascular disease remains uncertain. This study aimed to assess the effect of HT, initiated before the age of 60 years, on all-cause mortality and cardiovascular events in females using statins for primary prevention.

Method: This population-based, retrospective cohort study included all females aged 40-60 years in British Columbia, Canada, who used statins for primary prevention. The exposure was defined as systemic HT, including estrogen alone or combined with a progestogen, excluding local preparations of estrogen. The study used Cox proportional hazards models from the study start date to the outcome.

Results: After exact matching on age using up to a 1-to-4 match, 685 (20%) of the 3,425 statin users initiated HT within the first year of follow-up. HT use was not significantly associated with all-cause mortality after adjusting for confounders (adjusted hazard ratio [aHR], 1.17; 95% confidence interval [CI], 0.87-1.58). Similarly, for the secondary outcome of composite cardiovascular events, HT use did not significantly increase risk (aHR, 0.95; 95% CI, 0.75-1.20).

Conclusion: This study found that HT, when initiated before age 60 years, was not associated with an increased risk of all-cause mortality or cardiovascular events in females using statins for primary prevention.