“This data has important implications with regard to a possible protective effect of hormone replacement therapy (HRT) on atherosclerotic conditions, particularly in patients at higher risk for these conditions due to medical co-morbidities,” said Caron B. Rockman, MD, vascular and endovascular surgeon. “Our initial task was to gather information from a prospective database of patients who underwent vascular screening to identify them as postmenopausal. A questionnaire was used to determine their use of (HRT) peripheral artery disease was noted if their ankle-brachial index was less or equal to 0.9.”
Analysis was performed on 847,982 postmenopausal women; 433,178 (51.1 percent) reported having used hormone replacement therapy (HRT). The hormone replacement therapy (HRT) patients were slightly older than patients who had not used hormone replacement therapy (HRT) (64.7 years vs. 64.3 years). When hormone replacement therapy (HRT) patients were compared to non-HRT patients, the hormone replacement therapy (HRT) patients were significantly more likely to be Caucasian (93.6 percent vs. 83.3 percent), to have smoked cigarettes (42.8 percent vs. 40.6 percent), to have hypertension (47.9 percent vs. 45.1 percent) and to have hypercholesterolemia (55.0 percent vs. 51.5 percent).
Despite the increased prevalence of several atherosclerotic risk factors among women who used hormone replacement therapy (HRT), researchers found that the hormone replacement therapy (HRT) patients were significantly less likely to have PAD (3.3 percent vs. 4.1 percent). Multivariate analysis confirmed that hormone replacement therapy (HRT) was independently associated with a decreased risk of PAD (OR 0.8, 95 percent CI 0.78-0.82). In addition, hormone replacement therapy (HRT) patients were less likely to have diabetes (8.6 percent vs. 10.1 percent).
“The significant effect of hormone replacement therapy (HRT) on the prevalence for PAD was maintained in the patients with existing atherosclerotic risk factors,” added Dr. Rockman, “and in postmenopausal women with a smoking history, hypertension, hypercholesterolemia, or diabetes, the odds ratio of HRT use with regard to PAD remained 0.8.” This analysis of nearly 850,000 post-menopausal women clearly demonstrates an association between the use of hormone replacement therapy and a lower risk of having peripheral arterial occlusive disease.