HORMONE REPLACEMENT: Socioeconomic Factors Play Role
Post-menopausal women in the South and those with college degrees are the most likely to use hormone replacement therapy, prompting speculation that socioeconomic factors may play a larger role than clinical factors in determining HRT candidates, according to a study published in today's Annals of Internal Medicine. "We would like to think that people are making their decisions based on risks and benefits," said lead researcher Dr. Nancy Keating of Brigham and Women's Hospital in Boston. "But if that were true, we wouldn't expect this much variation based on geography and education," she said. USA Today reports that while the disparities found by the study may reflect the preferences of doctors and patients, they may also reflect some confusion over HRT's benefits and risks. While studies have indicated that HRT relieves menopausal symptoms, protects against osteoporosis and reduces heart disease risks, the drug therapy may increase a woman's risk of developing breast cancer. Keating and her colleagues interviewed nearly 500 women ages 50 to 74 in 1995 and found that 38% of the women used HRT. Of those women, 45% lived in the South, 42% in the West, 32% in the Midwest and 22% in the Northeast. Fifty-four percent of the participants who used HRT were college graduates, compared to 37% with high school diplomas and 30% without high school diplomas. The authors found that several clinical factors related to heart disease, including a woman's family and heart history, "had no noticeable effect on HRT use" (Painter, 4/6). In addition, although "diabetes puts a person at a significantly higher risk of heart disease, we found that HRT use was much lower among diabetic women compared to nondiabetic women," said co-author Dr. John Ayanian (Brigham and Women's Hospital release, 4/5).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.