Menopause, postmenopausal estrogen preparations, and the risk of adult-onset asthma. A prospective cohort study

• Published in: American journal of respiratory and critical care medicine Vol. 152; no. 4 Pt 1; p. 1183
• Main Authors: Troisi, R J, Speizer, F E, Willett, W C, Trichopoulos, D, Rosner, B
• Format: Journal Article
• Language: English
• Published: United States 01.10.1995
• Subjects: Adult; Age Factors; Asthma - chemically induced; Asthma - epidemiology; Asthma - physiopathology; Body Mass Index; Case-Control Studies; Cohort Studies; Contraceptives, Oral; Estrogen Replacement Therapy - adverse effects; Estrogens - physiology; Estrogens, Conjugated (USP) - adverse effects; Female; Humans; Incidence; Menopause - physiology; Middle Aged; Postmenopause - physiology; Progestins - adverse effects; Prospective Studies; Risk Factors; Smoking - epidemiology; Time Factors
• ISSN: 1073-449X
• DOI: 10.1164/ajrccm.152.4.7551368

We prospectively evaluated the association of hormone replacement therapy and asthma incidence in a cohort of pre- and postmenopausal women 34 to 68 yr of age. During 582, 135 person-years of follow-up between 1980 and 1990, 726 new cases of asthma were documented. Postmenopausal women who were never users of replacement hormones had a significantly lower age-adjusted risk of asthma than premenopausal women (relative risk = 0.65; 95% confidence interval [CI] = 0.46 to 0.92). Among naturally menopausal women, the age-adjusted relative risk of asthma for ever use of postmenopausal hormones was 1.49 (95% CI = 1.10 to 2.00); for current use of hormones (conjugated estrogens with or without progesterone), 1.50 (95% CI = 0.98 to 2.30); and for past use, 1.52 (95% CI = 1.08 to 2.13), compared with never use of hormones. Ever users of 10 or more years' duration had twice the age-adjusted risk of asthma compared with women who never used postmenopausal hormones (95% CI = 1.39 to 2.87). Among current users of conjugated estrogens, there was a positive dose-response demonstrated between daily dose and asthma risk (p for trend = 0.007). While confirmatory studies are warranted, these data suggest that estrogen plays a role in the pathophysiology of asthma and that long-term use and/or high doses of postmenopausal hormone therapy increase subsequent risk of asthma.