Effects of menopausal hormone therapy on cardiovascular diseases and type 2 diabetes in middle-aged postmenopausal women: analysis of the Korea National Health Insurance Service Database

Ji Eun Kim, Jaesung Choi, Joo Yong Park, Aesun Shin, Nam Kyong Choi, Ji Yeob Choi

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4 Scopus citations

Abstract

Objective:Although menopausal hormone therapy (MHT) is the most effective treatment for menopausal symptoms, menopausal women hesitate to start MHT due to concerns about adverse events. Recently, however, it has been recommended to use it for appropriate patients who have been evaluated for baseline diseases, age, and timing of initiation. We aimed to investigate the association of MHT with cardiovascular diseases (CVDs) and type 2 diabetes among middle-aged postmenopausal women in Korea.Methods:Data were collected from the National Health Insurance Service database in Korea from 2002 to 2016. A total of 58,060 postmenopausal women (including 8,013 [13.8%] MHT users and 50,047 [86.2%] nonusers) were included. The time-dependent Cox regression model with a 1-year latency period was used to evaluate the hazard ratio (HR) and 95% confidence interval (CI) of the associations of MHT with CVDs and type 2 diabetes outcomes. Subgroup analyses by regimen type and cumulative duration were conducted.Results:In the multivariate-adjusted model, MHT was not significantly associated with CVDs (HR = 1.085, 95% CI: 0.899-1.310) or type 2 diabetes (HR = 1.104, 95% CI: 0.998-1.221). Differential effects were not observed by regimen type, cumulative duration, and years since menopause subgroups. Sensitivity analyses also did not show adverse events by MHT on CVDs and type 2 diabetes.Conclusions:Although protective effects of MHT against CVDs or type 2 diabetes were not observed among postmenopausal women who had screened underlying diseases, our results may contribute to reducing the current concerns about the use of MHT for middle-aged postmenopausal women in Korea.

Original languageEnglish
Pages (from-to)1225-1232
Number of pages8
JournalMenopause
Volume28
Issue number11
DOIs
StatePublished - 13 Nov 2021

Bibliographical note

Funding Information:
Funding/support: This research was supported by a grant from the Cancer Research Institute (0431-20190010), Seoul National University Hospital (2021), the AMOREPACIFIC Foundation, the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2018R1A2A3075397), and the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea (HI19C1178). J.-E.K., J.C., and J.Y.P. received a scholarship from the BK21-plus education program.

Publisher Copyright:
© 2021 by The North American Menopause Society.

Keywords

  • Cardiovascular diseases
  • Menopausal hormone therapy
  • Postmenopausal women
  • Retrospective cohort study
  • Type 2 diabetes

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