Study suggests hormonal replacement therapy is linked to reduced risk of developing asthma in menopausal women
A study finds that hormonal replacement therapy is associated with a reduced risk of developing late onset asthma in menopausal women
A study published today in the Journal of Allergy and Clinical Immunology has found that use of estrogen-only and combined estrogen/progestogen hormone replacement therapy (HRT) was associated with reductions in the risk of development of asthma in menopausal women.
Hormonal Replacement Therapy
Previous studies of sex steroids, or HRT, have not been conclusive on their role in the development of asthma in menopausal women. The researchers in this study aimed to take a robust, long-term approach to clarify the evidence. It investigated the association of HRT use, its subtypes and its duration with the risk of developing asthma in menopausal women. This is the largest longitudinal study on the topic to date. The analysis also examined whether these associations changed due to differences in body mass index (BMI) and cigarette smoking.
Optimum Patient Care Research Database
The data for this study was derived from the Optimum Patient Care Research Database (OPCRD). This database consists of long-term, unidentifiable patient data from primary care practices across the UK.
The researchers constructed a retrospective participant group of women aged between 45 and 70 (peri- and post-menopausal) from the database, which included 353,173 women. They followed the participants’ data from 1st January 2000 until 31st December 2016.
Findings
Sixteen percent of the participants used some form of HRT (combined estrogen/progestogen HRT or estrogen-only HRT) at the beginning of the study. During the 17 years of follow-up, 7,614 new asthma cases were recorded.
If the women had used HRT previously, there was an 18% reduced risk of developing new onset asthma when comparing to no use of HRT. Similarly, women who had current use of any HRT had a 22% lower risk of developing asthma.
The study also found that the longer a woman used HRT, the lower their risk of asthma: 7% lower for 1-2 years’ use, 23% lower for 3-4 years’ use, and 29% for 5 or more years’ use. However, when divided into age, BMI or smoking groups, these effects become insignificant.
Future Studies
The results outlined in this paper can be generalised for the wider UK population, but future prospective studies should be carried out to confirm the findings.
This paper was written by several members of the Asthma UK Centre for Applied Research, including, Dr Syed Ahmar Shah, Holly Tibble, Dr Rebecca Pillinger, Susannah McLean, Dr Dermot Ryan, Professor Colin Simpson, Dr Ireneous Soyiri, Professor Aziz Sheikh and Dr Bright Nwaru. The Centre partner organisation, Optimum Patient Care was also involved in the study.
Lead author, Dr Syed Ahmar Shah said:
"Our study, the largest long-term study on the topic, provides promising results that hormone replacement therapy reduces the risk of new onset of asthma in menopausal women. There is now a need to undertake studies to understand the biological processes through which hormone replacement therapy influences the development of asthma."
Read the article
Read this article in the Journal of Allergy and Clinical Immunology
Cite as
Syed A. Shah, Holly Tibble, Rebecca Pillinger, Susannah McLean, Dermot Ryan, Hilary Critchley, David Price, Catherine M. Hawrylowicz, Colin R. Simpson, Ireneous N. Soyiri, Francis Appiagyei, Aziz Sheikh, Bright I. Nwaru (2020), Hormonal contraceptives and onset of asthma in reproductive-age women: Population-based cohort study, Journal of Allergy and Clinical Immunology (in press). DOI: https://doi.org/10.1016/j.jaci.2020.11.024
Image credit: MarsBars via Getty Images