The study, commissioned by the Institute and Faculty of Actuaries (IFoA), is the first to look at the impact of HRT on overall life expectancy using UK primary care data. It followed 105,199 healthy women aged 46 to 65 years at first HRT prescription over up to 32 years with an average follow-up of 13 years, and compared their outcomes with 224,643 non-users of the same age and GP practice.
Most previous studies adjusted for demographic and/or lifestyle factors only. The UEA research went much further, also adjusting for type 2 diabetes, hypertension and its treatments, coronary heart disease and oophorectomy/hysterectomy status, as well as body mass index, smoking and deprivation status.
Nick Steel, Clinical Professor in Public Health, Norwich Medical School, provided independent oversight of the research and said: “It’s exciting that this new research found that combined hormone replacement therapy (HRT) use was linked to an overall lower risk of death, and that oestrogen-only HRT was not linked to an increased risk of death.
“HRT use has been controversial for many years, as it offers symptomatic relief to many women but there have been conflicting reports about the long-term risk of breast cancer, as well as possible benefits to cardiovascular health. UK primary care data has now enabled long term follow-up of thousands of women in the UK, comparing the overall risk of death over many years for those using HRT with those not using it.”
The research comes as Labour MP Carolyn Harris is introducing a private member’s bill to change legislation so that women in England would not have to pay for HRT. The bill is due to receive its second reading on Friday 29 October.
Louise Pryor, IFoA President, said: “This study supports the emerging consensus that, for most women, the benefits of HRT outweighs the harm. We hope this research will help to inform the debate as the private member’s bill is considered in Parliament and also, support women deciding whether to start or continue with HRT.
“Delving into these complex, long-term, multi-faceted issues is where the IFoA’s Actuarial Research Centre can really add value. It provides a valuable lens for exploring some of the most pressing social and policy challenges of the 21st century through credible, evidence-based insight and analysis in the public interest.”
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