Am. J. Respir. Crit. Care Med., Volume 163, Number 2, February 2001, 423-428

Hormone Replacement Therapy Is Associated with Higher FEV₁ in Elderly Women

CATHERINE L. CARLSON, MARY CUSHMAN, PAUL L. ENRIGHT, JANE A. CAULEY, and ANNE B. NEWMAN, for the Cardiovascular Health Study Research Group

University of Pittsburgh, Pittsburgh, Pennsylvania; University of Vermont, Colchester, Vermont; and University of Arizona, Tucson, Arizona

Estrogen and progesterone use have been associated with improved pulmonary function in premenopausal women. However, little research has examined the relationship between hormone replacement therapy (HRT) and pulmonary function in postmenopausal women. We examined the relationship of HRT with spirometry in 2,353 women aged 65 yr and older participating in the Cardiovascular Health Study in 1993/1994. Current use of HRT was hypothesized to be associated with higher FEV₁, higher FVC, and less pulmonary obstruction (FEV₁/FVC < 65%). FEV₁ was higher among current HRT users compared to noncurrent users in the following groups: overall (1.82 L versus 1.66 L, p < 0.0001), among women without asthma (1.85 L versus 1.69 L, p < 0.0001), among former smokers (1.76 L versus 1.60 L, p = 0.013), and among never smokers (1.90 L versus 1.72 L, p < 0.0001). Overall, HRT use was associated with a lower prevalence of pulmonary obstruction (OR 0.75 [95% CI 0.55, 0.99]). After controlling for potential confounders, HRT use was significantly associated with higher FEV₁ (p = 0.031) and with a lower prevalence of obstruction (OR 0.67 [95% CI 0.48, 0.95]). We conclude that postmenopausal women who use HRT have higher levels of FEV₁ and less obstruction, which could not be explained by their lower rates of smoking and other health factors associated with HRT use.

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