A STUDY OF THE ASSOCIATION BETWEEN HORMONE REPLACEMENT THERAPY, SMOKING AND THE OCCURRENCE OF MYOCARDIAL-INFARCTION IN WOMEN

The initial results are reported of a case-control study undertaken on the VAMP multi-purpose database and designed to estimate the risk for first-time occurrence of myocardial infarction in users of hormone re placement therapy (HRT). The findings currently available relate to th e computerized data and show 2- to 5-fold increases in risk in smokers and those with diabetes mellitus, hypertension or hyperlipidaemia. Wi th any form of HRT, a non-significant protective effect [adjusted odds ratio = 0.83 with 95% CI (confidence intervals) of 0.66-1.03,p = 0.08 9] has been shown. However, the protective effect of HRT in the data a vailable to date appears to be confined to non-smokers in whom the odd s ratio in the absence of other risk factors is 0.70 (95% CI of 0.49-1 .00). The comparable odds ratio in smokers is 1.05 (95% CI of 0.71-1.5 3). These results should be interpreted with caution as smoking status was unknown for about half of the subjects and was more complete amon g the cases than controls.