Postmenopausal hormone therapy in the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil): who still uses it?

Aquino, Estela M. L.; Almeida, Maria-da-Conceição C.; Menezes, Greice Maria de Souza; Figueiredo, Rachel; Mengue, Sotero Serrate; Fonseca, Maria de Jesus Mendes da; Gabrielli, Lígia

doi:10.1002/pds.3992

Cited by 3 publications

(3 citation statements)

References 53 publications

(102 reference statements)

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“…Furthermore, use of MHT is expected to differ by age but stratification by age has often not been a focus in existing studies, partly due to sample size. In addition, published studies on MHT use are often based on older data and do thus not inform on recent trends and the current situation 15,18‐20 . In Germany, for example, the latest comprehensive report on MHT use is based on data from 2000 to 2005 21…”

Section: Introductionmentioning

confidence: 99%

Prescribing of menopausal hormone therapy in Germany: Current status and changes between 2004 and 2016

Heinig

Braitmaier

Haug

2021

Pharmacoepidemiology and Drug

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Background Prescribing of menopausal hormone therapy (MHT) declined drastically after publication of the Women's Health Initiative's (WHI) findings in 2002, but studies on longer‐term trends and details of use are scarce. Methods We used the German Pharmacoepidemiological Research Database (GePaRD) containing health insurance claims data from ~25 million persons. Using data from 2004–2016, we conducted cross‐sectional analyses to determine the prevalence of MHT use overall and by type and route of administration in women aged 45–75. In longitudinal analyses, we assessed MHT use over 5 years and compared the patterns between different time periods. Results From 2004 to 2016, prevalence of systemic MHT prescriptions decreased by >60% in women aged 55–65 and by >50% in women aged 50 and 70 years old. Prevalence declined for most types and routes of administration at all ages (−16% to −79%) with some exceptions, for example, local MHT (vaginal estrogen). Among 50‐year‐old women in 2012, 6% were already prescribed systemic MHT at age 49 and of the remaining women, 16% were newly prescribed systemic MHT before age 55. At all ages, the cumulative dose of systemic MHT prescribed over 5 years was lower in the period 2012–2016 compared to 2005–2009 (−6% to −46%). Conclusions For most types of MHT and all age groups, prevalence declined considerably between 2004 and 2016 in Germany. The cumulative dose per MHT user also decreased, suggesting a trend towards a shorter duration of use.

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Section: Introductionmentioning

confidence: 99%

Prescribing of menopausal hormone therapy in Germany: Current status and changes between 2004 and 2016

Heinig

Braitmaier

Haug

2021

Pharmacoepidemiology and Drug

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“…In fact, this decrease began in 2000 and coincides with the publication of the Women's Health Initiative (WHI) study (Rossouw et al, 2002). In Brazil, as in other countries, a reduction occurred in the prescription of hormone replacement therapy (HRT) (Aquino et al, 2016), making it reasonable to assume that the reduction in the incidence of breast cancer found in this study could be related to the decrease in the use of HRT.…”

Section: Discussionmentioning

confidence: 61%

Trends in the Incidence of Breast Cancer Following the Radiological Accident in Goiânia: A 25-Year Analysis

Rahal

Rocha

Freitas‐Júnior

et al. 2019

Asian Pac J Cancer Prev

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Background:The largest radiological accident to occur in any urban area happened in Goiânia, Brazil, in 1987. One major concern regarding deleterious effects in the population was a possible increase in the breast cancer incidence. This study analyzed trends in the incidence of breast cancer over the 25-year period following the radiological accident. Methods: This ecological, population-based study was conducted to determine the incidence of breast cancer in female residents of Goiânia, Goiás, Brazil, between 1988 and 2012. The data were collected from the Goiânia population-based cancer registry. Crude and age-standardized incidence rates were calculated. The Joinpoint software program was used to calculate annual percent changes (APC) in the incidence of breast cancer. Results: Overall, 7,365 new cases of breast cancer were identified, with an annual crude incidence rate of 23.09/100,000 women in 1988 and of 71.65/100,000 women in 2012. The age-standardized incidence rate was 35.63/100,000 women in 1988 and 65.63/100,000 women in 2012. Analysis of the APC showed a significant annual increase of 4.8% in the incidence between 1988 and 2005 (p<0.0001) followed by stabilization in 2005-2012, with an APC of -3.5% (p=0.1). Conclusion: There was an increase in the incidence of breast cancer in the female residents of Goiânia, Goiás in the first 17 years of evaluation (1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004) followed by a period of stabilization until 2012. However, the trends in the incidence suggest a lack of association with the radiological accident.

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“…Um estudo realizado no ELSA-Brasil demonstrou que mulheres com pelo menos uma contraindicação clínica à THM tinham probabilidade menor de serem expostas a esse tipo de medicamento. 23 Portanto, a prescrição da THM pode ter sido mais restrita no caso de mulheres com hipertensão, uma vez que, embora a hipertensão em si não seja uma contraindicação formal, ela é frequentemente associada a doenças para as quais o uso de hormônio seria contraindicado. Não obstante, os presentes resultados estão alinhados com os achados do Estudo de Rancho Bernardo realizados na Califórnia com 1.044 mulheres, em que os níveis de pressão arterial das participantes que usavam THM no momento eram mais baixos do que os do grupo de controle.…”

Section: Discussionunclassified

Terapia Hormonal e Hipertensão em Mulheres na Pós-Menopausa: Resultados do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil)

Ferreira-Campos¹,

Gabrielli²,

Almeida³

et al. 2022

Arquivos Brasileiros De Cardiologia

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Fundamento: A hipertensão arterial é considerada um importante fator de risco de morbidade e mortalidade cardiovascular em mulheres na pós-menopausa. Embora a terapia hormonal da menopausa (THM) seja um tratamento muito eficiente para sintomas vasomotores nesse período, a influência dessa terapia na pressão arterial ainda não está clara.Objetivo: Avaliar a relação entre o uso de THM e a hipertensão em participantes do ELSA-Brasil.Métodos: Um estudo transversal usando dados da linha de base da coorte ELSA-Brasil, com 2.138 mulheres que passaram por menopausa natural. Neste estudo, foi analisado a hipertensão, definida como pressão arterial ≥140/90 mmHg ou uso anterior de anti-hipertensivo, e o uso da THM, com participantes sendo classificadas em grupos daquelas que nunca usaram, que já usaram e que estavam em uso atual. As associações foram avaliadas usando-se um modelo de regressão logística multivariada com uma significância estatística definida em p<0,05. Resultados:No total, 1.492 mulheres (69,8%) nunca tinham usado a THM, 457 (21,4%) tinham usado no passado, e 189 (8,8%) estavam em uso atual. O uso de THM foi mais comum em mulheres que tinham índice de massa corporal <25 kg/m 2 e níveis de triglicérides <150 mg/dl, que eram fisicamente menos inativas, não fumantes e não diabéticas. As mulheres em uso atual da THM apresentaram menores chances de ter hipertensão (OR=0,59; IC 95%: 0,41-0,85), em comparação com as que nunca a usaram. Na maioria dos casos, a THM foi iniciada com idade até 59 anos, com menos de 10 anos de menopausa e o uso durou até cinco anos.Conclusão: O uso atual da THM não esteve relacionado à hipertensão, especialmente em mulheres saudáveis e que tinham menos de 60 anos de idade.

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Postmenopausal hormone therapy in the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil): who still uses it?

Abstract: Although the use of HT has declined in Brazil, the women who continue using it are largely exceeding evidence-based limits of age, time since menopause, and time of use. Copyright © 2016 John Wiley & Sons, Ltd.

Cited by 3 publications

References 53 publications

Prescribing of menopausal hormone therapy in Germany: Current status and changes between 2004 and 2016

Prescribing of menopausal hormone therapy in Germany: Current status and changes between 2004 and 2016

Trends in the Incidence of Breast Cancer Following the Radiological Accident in Goiânia: A 25-Year Analysis

Terapia Hormonal e Hipertensão em Mulheres na Pós-Menopausa: Resultados do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil)

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