Oophorectomy, hormone therapy, and subclinical coronary artery disease in women with hysterectomy: The Women's Health Initiative coronary artery calcium study

Matthew A. Allison, Jo Ann E. Manson, Robert D. Langer, J. Jeffrey Carr, Jacques E. Rossouw, Mary B. Pettinger, Lawrence Phillips, Barbara B. Cochrane, Charles B. Eaton, Philip Greenland, Susan Hendrix, Judith Hsia, Julie R. Hunt, Rebecca D. Jackson, Karen Johnson, Lewis H. Kuller, Jennifer Robinson

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Objective: Surgical menopause has been associated with an increased risk of coronary heart disease events. In this study, we aimed to determine the associations between coronary artery calcium (CAC) and hysterectomy, oophorectomy, and hormone therapy use with a focus on the duration of menopause for which there was no hormone therapy use. Design: In a substudy of the Women's Health Initiative placebo-controlled trial of conjugated equine estrogens (0.625 mg/d), we measured CAC by computed tomography 1.3 years after the trial was stopped. Participants included 1,064 women with previous hysterectomy, aged 50 to 59 years at baseline. The mean trial period was 7.4 years. Imaging was performed at a mean of 1.3 years after the trial was stopped. Results: Mean age was 55.1 years at randomization and 64.8 years at CAC measurement. In the overall cohort, there were no significant associations between bilateral oophorectomy, years since hysterectomy, years since hysterectomy without taking hormone therapy (HT), years since bilateral oophorectomy, and years of HT use before Women's Health Initiative enrollment and the presence of CAC. However, there was a significant interaction between bilateral oophorectomy and prerandomization HT use for the presence of any CAC (P = 0.05). When multivariable analyses were restricted to women who reported no previous HT use, those with bilateral oophorectomy had an odds ratio of 2.0 (95% CI: 1.2-3.4) for any CAC compared with women with no history of oophorectomy, whereas among women with unilateral or partial oophorectomy, the odds of any CAC was 1.7 (95% CI: 1.0-2.8). Among women with bilateral oophorectomy, HT use within 5 years of oophorectomy was associated with a lower prevalence of CAC. Conclusions: Among women with previous hysterectomy, subclinical coronary artery disease was more prevalent among those with oophorectomy and no prerandomization HT use, independent of traditional cardiovascular disease risk factors. The results suggest that factors related to oophorectomy and the absence of estrogen treatment in oophorectomized women may be related to coronary heart disease.

Original languageEnglish (US)
Pages (from-to)639-647
Number of pages9
JournalMenopause
Volume15
Issue number4
DOIs
StatePublished - Jul 1 2008

Fingerprint

Ovariectomy
Women's Health
Hysterectomy
Coronary Artery Disease
Coronary Vessels
Hormones
Calcium
Therapeutics
Menopause
Coronary Disease
Conjugated (USP) Estrogens
Random Allocation
Estrogens
Cardiovascular Diseases
Odds Ratio
Tomography
Placebos

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

Allison, M. A., Manson, J. A. E., Langer, R. D., Carr, J. J., Rossouw, J. E., Pettinger, M. B., ... Robinson, J. (2008). Oophorectomy, hormone therapy, and subclinical coronary artery disease in women with hysterectomy: The Women's Health Initiative coronary artery calcium study. Menopause, 15(4), 639-647. https://doi.org/10.1097/gme.0b013e31816d5b1c

Oophorectomy, hormone therapy, and subclinical coronary artery disease in women with hysterectomy : The Women's Health Initiative coronary artery calcium study. / Allison, Matthew A.; Manson, Jo Ann E.; Langer, Robert D.; Carr, J. Jeffrey; Rossouw, Jacques E.; Pettinger, Mary B.; Phillips, Lawrence; Cochrane, Barbara B.; Eaton, Charles B.; Greenland, Philip; Hendrix, Susan; Hsia, Judith; Hunt, Julie R.; Jackson, Rebecca D.; Johnson, Karen; Kuller, Lewis H.; Robinson, Jennifer.

In: Menopause, Vol. 15, No. 4, 01.07.2008, p. 639-647.

Research output: Contribution to journalArticle

Allison, MA, Manson, JAE, Langer, RD, Carr, JJ, Rossouw, JE, Pettinger, MB, Phillips, L, Cochrane, BB, Eaton, CB, Greenland, P, Hendrix, S, Hsia, J, Hunt, JR, Jackson, RD, Johnson, K, Kuller, LH & Robinson, J 2008, 'Oophorectomy, hormone therapy, and subclinical coronary artery disease in women with hysterectomy: The Women's Health Initiative coronary artery calcium study', Menopause, vol. 15, no. 4, pp. 639-647. https://doi.org/10.1097/gme.0b013e31816d5b1c
Allison, Matthew A. ; Manson, Jo Ann E. ; Langer, Robert D. ; Carr, J. Jeffrey ; Rossouw, Jacques E. ; Pettinger, Mary B. ; Phillips, Lawrence ; Cochrane, Barbara B. ; Eaton, Charles B. ; Greenland, Philip ; Hendrix, Susan ; Hsia, Judith ; Hunt, Julie R. ; Jackson, Rebecca D. ; Johnson, Karen ; Kuller, Lewis H. ; Robinson, Jennifer. / Oophorectomy, hormone therapy, and subclinical coronary artery disease in women with hysterectomy : The Women's Health Initiative coronary artery calcium study. In: Menopause. 2008 ; Vol. 15, No. 4. pp. 639-647.
@article{0681da2eeb3f4662b41debb8b430e9de,
title = "Oophorectomy, hormone therapy, and subclinical coronary artery disease in women with hysterectomy: The Women's Health Initiative coronary artery calcium study",
abstract = "Objective: Surgical menopause has been associated with an increased risk of coronary heart disease events. In this study, we aimed to determine the associations between coronary artery calcium (CAC) and hysterectomy, oophorectomy, and hormone therapy use with a focus on the duration of menopause for which there was no hormone therapy use. Design: In a substudy of the Women's Health Initiative placebo-controlled trial of conjugated equine estrogens (0.625 mg/d), we measured CAC by computed tomography 1.3 years after the trial was stopped. Participants included 1,064 women with previous hysterectomy, aged 50 to 59 years at baseline. The mean trial period was 7.4 years. Imaging was performed at a mean of 1.3 years after the trial was stopped. Results: Mean age was 55.1 years at randomization and 64.8 years at CAC measurement. In the overall cohort, there were no significant associations between bilateral oophorectomy, years since hysterectomy, years since hysterectomy without taking hormone therapy (HT), years since bilateral oophorectomy, and years of HT use before Women's Health Initiative enrollment and the presence of CAC. However, there was a significant interaction between bilateral oophorectomy and prerandomization HT use for the presence of any CAC (P = 0.05). When multivariable analyses were restricted to women who reported no previous HT use, those with bilateral oophorectomy had an odds ratio of 2.0 (95{\%} CI: 1.2-3.4) for any CAC compared with women with no history of oophorectomy, whereas among women with unilateral or partial oophorectomy, the odds of any CAC was 1.7 (95{\%} CI: 1.0-2.8). Among women with bilateral oophorectomy, HT use within 5 years of oophorectomy was associated with a lower prevalence of CAC. Conclusions: Among women with previous hysterectomy, subclinical coronary artery disease was more prevalent among those with oophorectomy and no prerandomization HT use, independent of traditional cardiovascular disease risk factors. The results suggest that factors related to oophorectomy and the absence of estrogen treatment in oophorectomized women may be related to coronary heart disease.",
author = "Allison, {Matthew A.} and Manson, {Jo Ann E.} and Langer, {Robert D.} and Carr, {J. Jeffrey} and Rossouw, {Jacques E.} and Pettinger, {Mary B.} and Lawrence Phillips and Cochrane, {Barbara B.} and Eaton, {Charles B.} and Philip Greenland and Susan Hendrix and Judith Hsia and Hunt, {Julie R.} and Jackson, {Rebecca D.} and Karen Johnson and Kuller, {Lewis H.} and Jennifer Robinson",
year = "2008",
month = "7",
day = "1",
doi = "10.1097/gme.0b013e31816d5b1c",
language = "English (US)",
volume = "15",
pages = "639--647",
journal = "Menopause",
issn = "1072-3714",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Oophorectomy, hormone therapy, and subclinical coronary artery disease in women with hysterectomy

T2 - The Women's Health Initiative coronary artery calcium study

AU - Allison, Matthew A.

AU - Manson, Jo Ann E.

AU - Langer, Robert D.

AU - Carr, J. Jeffrey

AU - Rossouw, Jacques E.

AU - Pettinger, Mary B.

AU - Phillips, Lawrence

AU - Cochrane, Barbara B.

AU - Eaton, Charles B.

AU - Greenland, Philip

AU - Hendrix, Susan

AU - Hsia, Judith

AU - Hunt, Julie R.

AU - Jackson, Rebecca D.

AU - Johnson, Karen

AU - Kuller, Lewis H.

AU - Robinson, Jennifer

PY - 2008/7/1

Y1 - 2008/7/1

N2 - Objective: Surgical menopause has been associated with an increased risk of coronary heart disease events. In this study, we aimed to determine the associations between coronary artery calcium (CAC) and hysterectomy, oophorectomy, and hormone therapy use with a focus on the duration of menopause for which there was no hormone therapy use. Design: In a substudy of the Women's Health Initiative placebo-controlled trial of conjugated equine estrogens (0.625 mg/d), we measured CAC by computed tomography 1.3 years after the trial was stopped. Participants included 1,064 women with previous hysterectomy, aged 50 to 59 years at baseline. The mean trial period was 7.4 years. Imaging was performed at a mean of 1.3 years after the trial was stopped. Results: Mean age was 55.1 years at randomization and 64.8 years at CAC measurement. In the overall cohort, there were no significant associations between bilateral oophorectomy, years since hysterectomy, years since hysterectomy without taking hormone therapy (HT), years since bilateral oophorectomy, and years of HT use before Women's Health Initiative enrollment and the presence of CAC. However, there was a significant interaction between bilateral oophorectomy and prerandomization HT use for the presence of any CAC (P = 0.05). When multivariable analyses were restricted to women who reported no previous HT use, those with bilateral oophorectomy had an odds ratio of 2.0 (95% CI: 1.2-3.4) for any CAC compared with women with no history of oophorectomy, whereas among women with unilateral or partial oophorectomy, the odds of any CAC was 1.7 (95% CI: 1.0-2.8). Among women with bilateral oophorectomy, HT use within 5 years of oophorectomy was associated with a lower prevalence of CAC. Conclusions: Among women with previous hysterectomy, subclinical coronary artery disease was more prevalent among those with oophorectomy and no prerandomization HT use, independent of traditional cardiovascular disease risk factors. The results suggest that factors related to oophorectomy and the absence of estrogen treatment in oophorectomized women may be related to coronary heart disease.

AB - Objective: Surgical menopause has been associated with an increased risk of coronary heart disease events. In this study, we aimed to determine the associations between coronary artery calcium (CAC) and hysterectomy, oophorectomy, and hormone therapy use with a focus on the duration of menopause for which there was no hormone therapy use. Design: In a substudy of the Women's Health Initiative placebo-controlled trial of conjugated equine estrogens (0.625 mg/d), we measured CAC by computed tomography 1.3 years after the trial was stopped. Participants included 1,064 women with previous hysterectomy, aged 50 to 59 years at baseline. The mean trial period was 7.4 years. Imaging was performed at a mean of 1.3 years after the trial was stopped. Results: Mean age was 55.1 years at randomization and 64.8 years at CAC measurement. In the overall cohort, there were no significant associations between bilateral oophorectomy, years since hysterectomy, years since hysterectomy without taking hormone therapy (HT), years since bilateral oophorectomy, and years of HT use before Women's Health Initiative enrollment and the presence of CAC. However, there was a significant interaction between bilateral oophorectomy and prerandomization HT use for the presence of any CAC (P = 0.05). When multivariable analyses were restricted to women who reported no previous HT use, those with bilateral oophorectomy had an odds ratio of 2.0 (95% CI: 1.2-3.4) for any CAC compared with women with no history of oophorectomy, whereas among women with unilateral or partial oophorectomy, the odds of any CAC was 1.7 (95% CI: 1.0-2.8). Among women with bilateral oophorectomy, HT use within 5 years of oophorectomy was associated with a lower prevalence of CAC. Conclusions: Among women with previous hysterectomy, subclinical coronary artery disease was more prevalent among those with oophorectomy and no prerandomization HT use, independent of traditional cardiovascular disease risk factors. The results suggest that factors related to oophorectomy and the absence of estrogen treatment in oophorectomized women may be related to coronary heart disease.

UR - http://www.scopus.com/inward/record.url?scp=51449106279&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=51449106279&partnerID=8YFLogxK

U2 - 10.1097/gme.0b013e31816d5b1c

DO - 10.1097/gme.0b013e31816d5b1c

M3 - Article

C2 - 18458645

AN - SCOPUS:51449106279

VL - 15

SP - 639

EP - 647

JO - Menopause

JF - Menopause

SN - 1072-3714

IS - 4

ER -