Hormonal replacement therapy, prothrombotic mutations and the risk of venous thrombosis

Rosendaal, F.R., Vessey, M., Rumley, A., Daly, E., Woodward, M., Helmerhorst, F.M. and Lowe, G.D. (2002) Hormonal replacement therapy, prothrombotic mutations and the risk of venous thrombosis. British Journal of Haematology, 116(4), pp. 851-854. (doi: 10.1046/j.0007-1048.2002.03356.x)

Abstract

Hormone replacement therapy (HRT) increases the risk of venous thrombosis. We investigated whether this risk is affected by carriership of hereditary prothrombotic abnormalities. Therefore, we determined the two most common prothrombotic mutations, factor V Leiden and prothrombin 20210A in women who participated in a case-control study on venous thrombosis. Relative risks were expressed as odds ratios (OR) with 95% confidence intervals (CI95). Among 7 7 women aged 45-64 years with a first venous thrombosis, 51% were receiving HRT at the time of thrombosis, compared with 24% of control women (OR = 3.3, CI95 1.8-5.8). Among the patients, 23% had a prothrombotic defect, versus 7% among the control women (OR = 3.8, CI95 1.7- 8.5). Women who had factor V Leiden and used HRT had a 15-fold increased risk (OR = 15.5, CI95 3.1-77), which exceeded the expected joint odds ratio of 6.1 (under an additive model). We conclude that the thrombotic risk of HRT may particularly affect women with prothrombotic mutations. Efforts to avoid HRT in women with increased risk of thrombosis are advisable.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Rumley, Dr Ann and Lowe, Professor Gordon and Woodward, Professor Mark
• Authors: Rosendaal, F.R., Vessey, M., Rumley, A., Daly, E., Woodward, M., Helmerhorst, F.M., and Lowe, G.D.
• Subjects: R Medicine > RC Internal medicine
• College/School: College of Medical Veterinary and Life Sciences; College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: British Journal of Haematology
• Publisher: Blackwell Publishing
• ISSN: 0007-1048
• Copyright Holders: © Blackwell Publishing
• First Published: First published in the British Journal of Haematology 116(4):851-854
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher