Increased Cardiovascular Mortality Risk in XXXX Discontinuing Postmenopausal Hormone Therapy.

@entity1 @entity64 @entity204 @entity65 @entity34
CONTEXT: Current guidelines recommend annual discontinuation of postmenopausal @entity34 ( @entity34 ) to evaluate whether a @entity1 could manage without the treatment. The impact of @entity34 on @entity65 has been widely studied, but it is not known how the withdrawal of @entity34 affects cardiovascular risk. OBJECTIVE: We evaluated the risk of cardiac or @entity64 death after the discontinuation of @entity34 . Design, @entity1 , Interventions, and Main Outcome Measures: Altogether 332 202 Finnish @entity1 discontinuing @entity34 between 1994 and 2009 (data from National Reimbursement register) were followed up from the discontinuation date to death due to cardiac cause (n = 3177) or @entity64 (n = 1952), or to the end of 2009. The deaths, retrieved from the national Cause of Death Register, were compared with the expected number of deaths in the age-standardized background population. In a subanalysis we also compared @entity34 stoppers with @entity34 users. RESULTS: Within the first posttreatment year, the risk of @entity204 was significantly elevated (standardized mortality ratio; 95% confidence interval 1.26; 1.16-1.37), whereas follow-up for longer than 1 year was accompanied with a reduction (0.75; 0.72-0.78). The risk of @entity64 death in the first posttreatment year was increased (1.63; 1.47-1.79), but follow-up for longer than 1 year was accompanied with a reduced risk (0.89; 0.85-0.94). The cardiac (2.30; 2.12-2.50) and @entity64 (2.52; 2.28-2.77) death risk elevations were even higher when compared with @entity34 users. In @entity1 who discontinued @entity34 at age younger than 60 years, but not in @entity1 aged 60 years or older, the cardiac mortality risk was elevated (1.94; 1.51-2.48). CONCLUSIONS: Increased @entity65 risks question the safety of annual @entity34 discontinuation practice to evaluate whether a @entity1 could manage without @entity34 .
