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| |  DG DISPATCH - ACCP: Link Suggested Between Estrogen Use And Asthma By Ed Susman Special to DG News
SAN FRANCISCO, CA -- October 24, 2000 -- Researchers analyzed data in the massive Nurses Health Study and found that postmenopausal women who use hormone replacement therapy appear to have nearly a doubled risk of developing asthma. More than 121,000 women since 1975 have been participating in this study. At enrollment, the women were between 30 and 55 years old. Dr. Graham Barr, MD, a fellow in respiratory epidemiology at Channing Laboratory at Brigham and Women's Hospital, Boston, Massachusetts, said previous studies indicated an increase in asthma among women during puberty and among women on estrogen-containing contraceptive pills. He wanted to determine if estrogen replacement after menopause also correlated with increases in asthma. In an oral presentation at the annual meeting of the American College of Chest Physicians (CHEST) in San Francisco, California, Dr. Barr said he found an 80 percent increase in the risk of asthma among women who used estrogen replacement and a doubled risk of developing asthma and chronic obstructive pulmonary disease (COPD). Dr. Barr said, however, that preliminary analysis of the data does not indicate that the development of asthma in these women leads to more healthcare utilization-especially urgent physician visits or emergency room visits-among these women. "This appears to be something that a physician should discuss with his patients as a question of informed consent," said Dr. John Mitchell, MD, chief of the pulmonary and chest center at Travis Air Force Base, California. Dr. Mitchell said that the concern over asthma should not outweigh the benefits of estrogen in reducing the risk of other conditions, such as heart disease and osteoporosis, in postmenopausal women. He said the studies do not explain if the women are predisposed to asthma or whether the inclusion of estrogen worsens symptoms that are already present. Dr. Barr said that estrogen has pro-inflammatory effects, which may be relevant to the inflammatory components of asthma and COPD. In the nurses study, all the participants are sent questionnaires about their health status every two years. In 1998 a supplemental questionnaire was sent to the women to confirm cases of asthma or COPD. Among postmenopausal women who had never used estrogen replacement therapy there were 255 new cases of asthma. Among women who had used estrogen replacement in the past there were 174 asthma cases. There were 195 cases of asthma among women using conjugated estrogen formulations and 132 cases of women using combination of estrogen and progestin formulation. That amounted to an odds ration of 1.8 -- an increased risk of 80 percent for all estrogen users, Dr. Barr reported.
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