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Stopping HT increases hip fracture risk

Hip fracture is more common among postmenopausal women who stop hormone therapy (HT) compared with those who continue HT, according to observational data presented here.

"Rising hip fracture risk in elderly postmenopausal women may be partially attributed to the continued decline in HT use. HT-related benefits of hip fracture do not carry over after cessation," said lead investigator Roksana Karim, PhD, MBBS, assistant professor of research, departments of pediatrics and preventive medicine, University of Southern California, Los Angeles. According to her data, the risk of hip fracture seems to increase starting at year 2 after cessation of HT.

The hip fracture rate increased from 3.9 per 1,000 women to 5.7 per 1,000 women over the study period at the same time that the prescription rate for HT dropped from 85% to 18%.

After adjusting for age and race, women who discontinued HT had a 55% greater risk of hip fracture than those who continued using HT. Adjusting for body mass index and the use of anti-osteoporotic medication did not alter the hazard ratio, said Karim,.

In assessing hip fracture risk according to the total number of years of not taking HT since 2002, a significantly increased risk of hip fracture was found with 2 or more years of HT nonuse.

"These results have economic and public health implications," Karim said. "The estimated annual cost of osteoporotic fracture in the US is $18 billion, and hip fracture results in greater cost and disability than all other fractures combined."

She noted that the risk of mortality also increases by 6-fold within 3 months of hip fracture, a risk that increases further over time.