TY - JOUR
T1 - A prospective evaluation of the risk of QT prolongation with hormone replacement therapy
T2 - The atherosclerosis risk in communities study
AU - Carnethon, Mercedes R.
AU - Anthony, Mary S.
AU - Cascio, Wayne E.
AU - Folsom, Aaron R.
AU - Rautaharju, Pentti M.
AU - Liao, Duanping
AU - Evans, Gregory W.
AU - Heiss, Gerardo
N1 - Funding Information:
The authors thank the staff and participants in the ARIC study for their important contributions. Support provided by National Heart, Lung, and Blood Institute ARIC Contracts: N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, N01-HC-55022; and HRV Grant: 5 R01 HL55669; and supported by NIH/NHLBI NRSA Training Grant: 5T32HL07034-26
PY - 2003/8
Y1 - 2003/8
N2 - PURPOSE: Prolongation of the QT interval is associated with an increased risk of arrhythmia, coronary heart disease (CHD), and mortality. Estrogens and androgens have been proposed as a causal factor in QT lengthening. We tested whether postmenopausal hormone replacement therapy was associated with prolonged QT intervals in a healthy population sample of women (mean age = 54). METHODS: Women (n = 3,103) were asked about estrogen (ERT) and progestin plus estrogen (PERT) replacement therapy use at 4 examinations over 9 years. Electrocardiographic QT intervals were measured and corrected for heart rate using the QT Index (QTI) and Bazett's correction. QT prolongation was defined as QTI > 110% and a change from baseline of ≥4%. RESULTS: Heart rate corrected QT length was moderately but significantly (p<0.01) greater, and the risk of QT prolongation was nearly twice (Odds Ratio = 1.9, 95% Confidence Interval: 1.2-2.0) that in women who used ERT compared with never users. PERT use was not significantly associated with QT length. CONCLUSIONS: The potential for slight increases in QT length over time, and an increased risk of QT prolongation with ERT use identified in this observational study, are important concerns that should be further explored in randomized trials.
AB - PURPOSE: Prolongation of the QT interval is associated with an increased risk of arrhythmia, coronary heart disease (CHD), and mortality. Estrogens and androgens have been proposed as a causal factor in QT lengthening. We tested whether postmenopausal hormone replacement therapy was associated with prolonged QT intervals in a healthy population sample of women (mean age = 54). METHODS: Women (n = 3,103) were asked about estrogen (ERT) and progestin plus estrogen (PERT) replacement therapy use at 4 examinations over 9 years. Electrocardiographic QT intervals were measured and corrected for heart rate using the QT Index (QTI) and Bazett's correction. QT prolongation was defined as QTI > 110% and a change from baseline of ≥4%. RESULTS: Heart rate corrected QT length was moderately but significantly (p<0.01) greater, and the risk of QT prolongation was nearly twice (Odds Ratio = 1.9, 95% Confidence Interval: 1.2-2.0) that in women who used ERT compared with never users. PERT use was not significantly associated with QT length. CONCLUSIONS: The potential for slight increases in QT length over time, and an increased risk of QT prolongation with ERT use identified in this observational study, are important concerns that should be further explored in randomized trials.
KW - Arrhythmia
KW - Coronary Heart Diseases
KW - Electrocardiography
KW - Hormone Replacement Therapy
KW - Postmenopause
KW - Women
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U2 - 10.1016/S1047-2797(03)00050-4
DO - 10.1016/S1047-2797(03)00050-4
M3 - Article
C2 - 12932629
AN - SCOPUS:0042160091
SN - 1047-2797
VL - 13
SP - 530
EP - 536
JO - Annals of Epidemiology
JF - Annals of Epidemiology
IS - 7
ER -