Hormones and Cardiovascular Disease
Director: Pierre-Yves Scarabin

Hormones and Cardiovascular Disease
Director: Pierre-Yves Scarabin

Hormones and Cardiovascular Disease
Director: Pierre-Yves Scarabin

 

We are investigating the impact of hormone therapy on the development of cardiovascular disease in the E3N cohort study (in collaboration with the group of Francoise Chapelon-Clavel). Cardiovascular disease includes both VTE and arterial disease (i.e. myocardial infarction and stroke). E3N is a cohort study set up in 1990 among about 100.000 french women born between 1925 and 1950 and insured by the Mutuelle Générale de l’Education Nationale (MGEN). Clinical outcomes are identified through biennal self-administered questionnaires. We are responsible for the definition and the validation of cardiovascular events. Women are asked to complete specific cardiovascular questionnaires. Following self-reported clinical events, relevant medical information is sought directly from the hospital or general practitioner records. All women are flagged with Cepi DC Inserm, and we use death certificates coded to International Classification of Diseases-10th revision (ICD 10) as our definition of fatal coronary heart disease, VTE and stroke.

 

A medical Committee has been established to provide an independent validation of clinical events. Stroke events are classified as ischemic or hemorrhagic based on a review of brain imaging studies. From questionnaires completed 1990 to 2002, more than 1,200 women had a documented VTE event. A first analysis of data regarding the VTE risk in relation to Hormone Therapy (HT) confirmed the findings of the ESTHER study. The route of estrogen administration as well as the type of progestogen are important determinants of the VTE risk among postmenopausal women who use HT. Transdermal estrogen alone or combined with either micronised progesterone or pregnane derivatives may be safe with respect to VTE risk. Validation and analysis of arterial events are in progress.

Finally, we are participating via E3N to the cardiovascular component of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The EPIC-heart study will investigate the influences of life-style, nutrition, environmental, metabolic and genetic factors in the development of cardiovascular diseases among more than 500,000 midlle-aged participants from 10 European countries.

© Esther 2019