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Cohort study of the association of hypnotic use with mortality in postmenopausal women.

ABSTRACT: Previous studies found an association between hypnotic use and mortality risk. The prospective outcome data and the many baseline risk factors included in the Women's Health Initiative (WHI) provide an opportunity to better understand the reasons for this association.The WHI is a long-term national health study that focused on strategies for preventing disease in postmenopausal women. Participants were enrolled from 1993 to 1998.Baseline hypnotic use was evaluated for an association with subsequent mortality or disease after adjusting for baseline risk.148 938 postmenopausal women between the ages of 50 and 79 throughout the USA. The median follow-up was 8 years.Mortality. Secondary outcomes included myocardial infarction, stroke, diabetes and seven types of cancer.For persons who use hypnotic medications almost daily the age-adjusted hazard ratio (HR) for mortality was 1.62 (95% CI 1.50 to 1.74). Greater hypnotic use was associated with less healthy levels of physical function, general health and smoking at baseline. After adjustment for these factors the HR for almost daily hypnotic use was 1.14 (1.06 to 1.23) for mortality and 1.53 (1.18 to 1.99) for melanoma; it was not significantly associated with increased incidence of other diseases tested. Less frequent hypnotic use and several types of sleeping difficulties were not associated with mortality, but sleeping more than 10 h a night had a risk-adjusted HR for mortality of 1.28 (1.01 to 1.61).The association of hypnotic use with mortality and incident disease was greatly reduced after adjusting for baseline risk factors. These findings do not support a strong independent association of hypnotic use with most health outcomes.

SUBMITTER: Hartz A

PROVIDER: S-EPMC3467595 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Cohort study of the association of hypnotic use with mortality in postmenopausal women.

Hartz Arthur A Ross John Jacob JJ

BMJ open 20120912 5

<h4>Objective</h4>Previous studies found an association between hypnotic use and mortality risk. The prospective outcome data and the many baseline risk factors included in the Women's Health Initiative (WHI) provide an opportunity to better understand the reasons for this association.<h4>Setting</h4>The WHI is a long-term national health study that focused on strategies for preventing disease in postmenopausal women. Participants were enrolled from 1993 to 1998.<h4>Design</h4>Baseline hypnotic ...[more]

PMID: 22977185

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Project description:ObjectiveTo examine the association between smoking and risk of invasive breast cancer using quantitative measures of lifetime passive and active smoking exposure among postmenopausal women.DesignProspective cohort study.Setting40 clinical centres in the United States.Participants79,990 women aged 50-79 enrolled in the Women's Health Initiative Observational Study during 1993-8.Main outcome measuresSelf reported active and passive smoking, pathologically confirmed invasive breast cancer.ResultsIn total, 3520 incident cases of invasive breast cancer were identified during an average of 10.3 years of follow-up. Compared with women who had never smoked, breast cancer risk was elevated by 9% among former smokers (hazard ratio 1.09 (95% CI 1.02 to 1.17)) and by 16% among current smokers (hazard ratio 1.16 (1.00 to 1.34)). Significantly higher breast cancer risk was observed in active smokers with high intensity and duration of smoking, as well as with initiation of smoking in the teenage years. The highest breast cancer risk was found among women who had smoked for ≥ 50 years or more (hazard ratio 1.35 (1.03 to 1.77) compared with all lifetime non-smokers, hazard ratio 1.45 (1.06 to 1.98) compared with lifetime non-smokers with no exposure to passive smoking). An increased risk of breast cancer persisted for up to 20 years after smoking cessation. Among women who had never smoked, after adjustment for potential confounders, those with the most extensive exposure to passive smoking (≥ 10 years' exposure in childhood, ≥ 20 years' exposure as an adult at home, and ≥ 10 years' exposure as an adult at work) had a 32% excess risk of breast cancer compared with those who had never been exposed to passive smoking (hazard ratio 1.32 (1.04 to 1.67)). However, there was no significant association in the other groups with lower exposure and no clear dose response to cumulative passive smoking exposure.ConclusionsActive smoking was associated with an increase in breast cancer risk among postmenopausal women. There was also a suggestion of an association between passive smoking and increased risk of breast cancer.

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Cohort study of the association of hypnotic use with mortality in postmenopausal women.

Publications

Cohort study of the association of hypnotic use with mortality in postmenopausal women.

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