{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T17:27:42Z","timestamp":1786296462318,"version":"build-2736575974"},"reference-count":51,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi231404-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Although hormone therapy (HT) in perimenopausal women is associated with increased risk for venous thromboembolism (VTE), it is unclear to what extent statins may mitigate this HT-associated risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi231404-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate VTE risk in women aged 50 to 64 years taking HT with or without statins.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi231404-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This nested case-control study analyzed data from a commercially insured claims database in the US. Eligible participants included women aged 50 to 64 years with at least 1 year of continuous enrollment between 2008 and 2019. Data analysis occurred from January 2022 to August 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi231404-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Filled prescriptions for estrogens, progestogens, and statins were recorded in the 12 months prior to index. Recent HT was defined as any estrogen or progestogen exposure within 60 days before the index date. Current statin exposure was defined as 90 or more days of continuous exposure prior to and including the index date. Statin intensity was defined by the statin exposure 30 days prior to index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi231404-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Cases were identified with VTE diagnoses (diagnostic codes) preceded by at least 12 months without VTE and followed within 30 days by anticoagulation, an inferior vena cava filter placement, or death. Controls were matched to cases (10:1) on date and age. Conditional logistic regression models estimated risk for HT and statin exposures with odds ratios (OR), adjusted for comorbidities. Conditional logistic regression models were used to estimate VTE risk for HT and statin exposures with odds ratios (ORs), adjusted for comorbidities. Intensity of statin therapy was measured as a subgroup analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi231404-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The total sample of 223\u202f949 individuals (mean [SD] age, 57.5 [4.4] years) included 20\u202f359 cases and 203\u202f590 matched controls. Of the entire sample, 19\u202f558 individuals (8.73%) had recent HT exposure and 36\u202f238 individuals (16.18%) had current statin exposure. In adjusted models, individuals with any recent HT exposure had greater odds of VTE compared with those with no recent HT exposure (OR, 1.51; 95% CI, 1.43-1.60). Individuals receiving current statin therapy had lower odds of VTE compared with those with no current statin exposure (OR, 0.88; 95% CI, 0.84-0.93). When compared with those not recently taking HT or statins, the odds of VTE were greater for those taking HT without statins (OR, 1.53; 95% CI, 1.44-1.63) and for those taking HT with statins (OR, 1.25; 95% CI, 1.10-1.43), but were lower for those taking statins without HT (OR, 0.89; 95% CI, 0.85-0.94). Individuals taking HT with statin therapy had 18% lower odds of VTE than those taking HT without statins (OR, 0.82; 95% CI, 0.71-0.94) and there was greater risk reduction with higher intensity statins.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi231404-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this case-control study, statin therapy was associated with reduced risk of VTE in women taking HT, with greater risk reduction with high-intensity statins. These findings suggest that statins may reduce risk of VTE in women exposed to HT and that HT may not be contraindicated in women taking statins.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.48213","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T11:31:14Z","timestamp":1702639874000},"page":"e2348213","source":"Crossref","is-referenced-by-count":15,"title":["Statin Use and the Risk of Venous Thromboembolism in Women Taking Hormone Therapy"],"prefix":"10.1001","volume":"6","author":[{"given":"John W.","family":"Davis","sequence":"first","affiliation":[{"name":"Department of Population Health Science, School of Public and Population Health, University of Texas Medical Branch, Galveston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan C.","family":"Weller","sequence":"additional","affiliation":[{"name":"Department of Population Health Science, School of Public and Population Health, University of Texas Medical Branch, Galveston"},{"name":"Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Porterfield","sequence":"additional","affiliation":[{"name":"Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston"},{"name":"Department of Family Medicine, School of Medicine, University of Texas Medical Branch, Galveston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Population Health Science, School of Public and Population Health, University of Texas Medical Branch, Galveston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg S.","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Department of Population Health Science, School of Public and Population Health, University of Texas Medical Branch, Galveston"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"issue":"11","key":"zoi231404r1","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1111\/jaan.2007.19.issue-11","article-title":"Perimenopausal symptoms, quality of life, and health behaviors in users and nonusers of hormone therapy.","volume":"19","author":"Twiss","year":"2007","journal-title":"J Am Acad Nurse Pract"},{"issue":"4","key":"zoi231404r2","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1001\/jamainternmed.2014.8063","article-title":"Duration of menopausal vasomotor symptoms over the menopause transition.","volume":"175","author":"Avis","year":"2015","journal-title":"JAMA Intern Med"},{"issue":"4","key":"zoi231404r3","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1038\/nrendo.2017.180","article-title":"Symptoms of menopause: global prevalence, physiology and implications.","volume":"14","author":"Monteleone","year":"2018","journal-title":"Nat Rev Endocrinol"},{"issue":"4","key":"zoi231404r4","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002978.pub2","article-title":"Oral oestrogen and combined oestrogen\/progestogen therapy versus placebo for hot flushes.","volume":"2004","author":"Maclennan","year":"2004","journal-title":"Cochrane Database Syst Rev"},{"issue":"10","key":"zoi231404r5","doi-asserted-by":"publisher","first-page":"668","DOI":"10.3390\/medicina55100668","article-title":"Cognition, mood and sleep in menopausal transition: the role of menopause hormone therapy.","volume":"55","author":"Gava","year":"2019","journal-title":"Medicina (Kaunas)"},{"issue":"13","key":"zoi231404r6","doi-asserted-by":"publisher","first-page":"1573","DOI":"10.1001\/jama.292.13.1573","article-title":"Estrogen plus progestin and risk of venous thrombosis.","volume":"292","author":"Cushman","year":"2004","journal-title":"JAMA"},{"issue":"3","key":"zoi231404r7","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1097\/AOG.0b013e318265df42","article-title":"A sustained decline in postmenopausal hormone use: results from the national health and nutrition examination survey, 1999-2010.","volume":"120","author":"Sprague","year":"2012","journal-title":"Obstet Gynecol"},{"issue":"5","key":"zoi231404r8","doi-asserted-by":"publisher","first-page":"1771","DOI":"10.1210\/jc.2012-4070","article-title":"Where are we 10 years after the Women\u2019s Health Initiative?","volume":"98","author":"Lobo","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"issue":"14","key":"zoi231404r9","doi-asserted-by":"publisher","first-page":"1701","DOI":"10.1001\/jama.291.14.1701","article-title":"Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women\u2019s Health Initiative randomized controlled trial.","volume":"291","author":"Anderson","year":"2004","journal-title":"JAMA"},{"issue":"1","key":"zoi231404r10","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1001\/jama.288.1.49","article-title":"Cardiovascular disease outcomes during 6.8 years of hormone therapy: Heart and Estrogen\/progestin Replacement Study follow-up (HERS II).","volume":"288","author":"Grady","year":"2002","journal-title":"JAMA"},{"issue":"1","key":"zoi231404r11","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004143.pub5","article-title":"Long-term hormone therapy for perimenopausal and postmenopausal women.","volume":"1","author":"Marjoribanks","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"zoi231404r12","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1001\/jama.288.3.321","article-title":"Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women\u2019s Health Initiative randomized controlled trial.","volume":"288","author":"Rossouw","year":"2002","journal-title":"JAMA"},{"issue":"1","key":"zoi231404r13","doi-asserted-by":"publisher","first-page":"20631","DOI":"10.1038\/s41598-020-77534-9","article-title":"A systematic review and meta-analysis of effects of menopausal hormone therapy on cardiovascular diseases.","volume":"10","author":"Kim","year":"2020","journal-title":"Sci Rep"},{"issue":"11","key":"zoi231404r14","doi-asserted-by":"publisher","first-page":"2277","DOI":"10.1111\/j.1538-7836.2012.04919.x","article-title":"Venous thromboembolism risk in relation to use of different types of postmenopausal hormone therapy in a large prospective study.","volume":"10","author":"Sweetland","year":"2012","journal-title":"J Thromb Haemost"},{"issue":"3","key":"zoi231404r15","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpth.2023.100135","article-title":"Hormone exposure and venous thromboembolism in commercially insured women aged 50 to 64 years.","volume":"7","author":"Weller","year":"2023","journal-title":"Res Pract Thromb Haemost"},{"issue":"6","key":"zoi231404r16","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1097\/GME.0000000000000611","article-title":"Risk of venous thromboembolism associated with local and systemic use of hormone therapy in peri- and postmenopausal women and in relation to type and route of administration.","volume":"23","author":"Bergendal","year":"2016","journal-title":"Menopause"},{"key":"zoi231404r17","doi-asserted-by":"publisher","first-page":"k4810","DOI":"10.1136\/bmj.k4810","article-title":"Use of hormone replacement therapy and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases.","volume":"364","author":"Vinogradova","year":"2019","journal-title":"BMJ"},{"issue":"6","key":"zoi231404r18","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1097\/gme.0b013e3181e102eb","article-title":"Activated protein C resistance among postmenopausal women using transdermal estrogens: importance of progestogen.","volume":"17","author":"Canonico","year":"2010","journal-title":"Menopause"},{"issue":"5","key":"zoi231404r19","doi-asserted-by":"publisher","first-page":"429","DOI":"10.3109\/13697137.2010.507111","article-title":"Transdermal hormone therapy and the risk of stroke and venous thrombosis.","volume":"13","author":"Speroff","year":"2010","journal-title":"Climacteric"},{"issue":"13","key":"zoi231404r20","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1001\/jama.2013.278040","article-title":"Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women\u2019s Health Initiative randomized trials.","volume":"310","author":"Manson","year":"2013","journal-title":"JAMA"},{"issue":"1","key":"zoi231404r21","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1089\/jwh.2006.15.35","article-title":"Hormone therapy and coronary heart disease: the role of time since menopause and age at hormone initiation.","volume":"15","author":"Grodstein","year":"2006","journal-title":"J Womens Health (Larchmt)"},{"issue":"3","key":"zoi231404r22","doi-asserted-by":"publisher","DOI":"10.1002\/14651858","article-title":"Hormone therapy for preventing cardiovascular disease in post-menopausal women.","volume":"2015","author":"Boardman","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"issue":"9841","key":"zoi231404r23","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1016\/S0140-6736(12)60367-5","article-title":"The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials.","volume":"380","author":"Mihaylova","year":"2012","journal-title":"Lancet"},{"issue":"10059","key":"zoi231404r24","doi-asserted-by":"publisher","first-page":"2532","DOI":"10.1016\/S0140-6736(16)31357-5","article-title":"Interpretation of the evidence for the efficacy and safety of statin therapy.","volume":"388","author":"Collins","year":"2016","journal-title":"Lancet"},{"issue":"2","key":"zoi231404r25","doi-asserted-by":"publisher","first-page":"e83","DOI":"10.1016\/S2352-3026(16)30184-3","article-title":"Statins and primary prevention of venous thromboembolism: a systematic review and meta-analysis.","volume":"4","author":"Kunutsor","year":"2017","journal-title":"Lancet Haematol"},{"issue":"18","key":"zoi231404r26","doi-asserted-by":"publisher","first-page":"1851","DOI":"10.1056\/NEJMoa0900241","article-title":"A randomized trial of rosuvastatin in the prevention of venous thromboembolism.","volume":"360","author":"Glynn","year":"2009","journal-title":"N Engl J Med"},{"issue":"9","key":"zoi231404r27","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1097\/GME.0000000000000279","article-title":"Concurrent use of statins and hormone therapy and risk of venous thromboembolism in postmenopausal women: a population-based case-control study.","volume":"21","author":"Fournier","year":"2014","journal-title":"Menopause"},{"issue":"25","key":"zoi231404r28","doi-asserted-by":"publisher","first-page":"2962","DOI":"10.1161\/01.CIR.0000019406.74017.B2","article-title":"Statin therapy, cardiovascular events, and total mortality in the Heart and Estrogen\/Progestin Replacement Study (HERS).","volume":"105","author":"Herrington","year":"2002","journal-title":"Circulation"},{"issue":"13","key":"zoi231404r29","doi-asserted-by":"publisher","first-page":"1531","DOI":"10.1161\/01.CIR.0000013837.81710.DA","article-title":"Statin attenuates increase in C-reactive protein during estrogen replacement therapy in postmenopausal women.","volume":"105","author":"Koh","year":"2002","journal-title":"Circulation"},{"issue":"4","key":"zoi231404r30","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1097\/GME.0000000000000345","article-title":"Hormone therapy and risk of cardiovascular outcomes and mortality in women treated with statins.","volume":"22","author":"Berglind","year":"2015","journal-title":"Menopause"},{"issue":"2","key":"zoi231404r31","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-054669","article-title":"Incidence of venous thrombotic events and events of special interest in a retrospective cohort of commercially insured US patients.","volume":"12","author":"Weller","year":"2022","journal-title":"BMJ Open"},{"issue":"1","key":"zoi231404r32","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1001\/jamacardio.2016.4700","article-title":"National trends in statin use and expenditures in the US adult population from 2002 to 2013: insights from the Medical Expenditure Panel Survey.","volume":"2","author":"Salami","year":"2017","journal-title":"JAMA Cardiol"},{"issue":"6","key":"zoi231404r33","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1097\/GME.0000000000001054","article-title":"Trends in oral and vaginally administered estrogen use among US women 50 years of age or older with commercial health insurance.","volume":"25","author":"Weissfeld","year":"2018","journal-title":"Menopause"},{"key":"zoi231404r34","doi-asserted-by":"publisher","first-page":"S31","DOI":"10.4103\/sja.SJA_543_18","article-title":"The STROBE guidelines.","volume":"13","author":"Cuschieri","year":"2019","journal-title":"Saudi J Anaesth"},{"issue":"13","key":"zoi231404r36","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.1001\/jama.2021.0278","article-title":"Trends in age at natural menopause and reproductive life span among US women, 1959-2018.","volume":"325","author":"Appiah","year":"2021","journal-title":"JAMA"},{"issue":"2","key":"zoi231404r38","doi-asserted-by":"publisher","first-page":"e38","DOI":"10.1161\/ATV.0000000000000073","article-title":"Statin safety and associated adverse events: a scientific statement from the American Heart Association.","volume":"39","author":"Newman","year":"2019","journal-title":"Arterioscler Thromb Vasc Biol"},{"issue":"11","key":"zoi231404r40","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.1097\/01.mlr.0000182534.19832.83","article-title":"Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data.","volume":"43","author":"Quan","year":"2005","journal-title":"Med Care"},{"issue":"4","key":"zoi231404r41","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1097\/01.mlr.0000118861.56848.ee","article-title":"Comparison of the Elixhauser and Charlson\/Deyo methods of comorbidity measurement in administrative data.","volume":"42","author":"Southern","year":"2004","journal-title":"Med Care"},{"key":"zoi231404r42","doi-asserted-by":"publisher","first-page":"57","DOI":"10.3389\/fpubh.2018.00057","article-title":"Unconditional or conditional logistic regression model for age-matched case-control data?","volume":"6","author":"Kuo","year":"2018","journal-title":"Front Public Health"},{"issue":"6","key":"zoi231404r43","doi-asserted-by":"publisher","first-page":"1220","DOI":"10.1160\/TH15-10-0775","article-title":"Use of statins and reduced risk of recurrence of VTE in an older population: a population-based cohort study.","volume":"115","author":"Tagalakis","year":"2016","journal-title":"Thromb Haemost"},{"issue":"3","key":"zoi231404r44","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1093\/cvr\/cvab078","article-title":"Rosuvastatin for the prevention of venous thromboembolism: a pooled analysis of the HOPE-3 and JUPITER randomized controlled trials.","volume":"118","author":"Joseph","year":"2022","journal-title":"Cardiovasc Res"},{"issue":"10","key":"zoi231404r45","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1016\/j.numecd.2019.06.022","article-title":"Statins and risk of thromboembolism: a meta-regression to disentangle the efficacy-to-effectiveness gap using observational and trial evidence.","volume":"29","author":"Miksza","year":"2019","journal-title":"Nutr Metab Cardiovasc Dis"},{"issue":"5","key":"zoi231404r46","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1111\/j.1538-7836.2010.03839.x","article-title":"Hormone replacement therapy and the risk of venous thromboembolism: a population-based study.","volume":"8","author":"Renoux","year":"2010","journal-title":"J Thromb Haemost"},{"issue":"8","key":"zoi231404r47","doi-asserted-by":"publisher","first-page":"1611","DOI":"10.1111\/j.1538-7836.2005.01415.x","article-title":"Venous thromboembolism: disease burden, outcomes and risk factors.","volume":"3","author":"Heit","year":"2005","journal-title":"J Thromb Haemost"},{"issue":"14","key":"zoi231404r48","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.1161\/CIRCULATIONAHA.114.008799","article-title":"Race and venous thromboembolism: nature or nurture?","volume":"129","author":"Goldhaber","year":"2014","journal-title":"Circulation"},{"issue":"14","key":"zoi231404r49","doi-asserted-by":"publisher","first-page":"1502","DOI":"10.1161\/CIRCULATIONAHA.113.006472","article-title":"Racial and regional differences in venous thromboembolism in the United States in 3 cohorts.","volume":"129","author":"Zakai","year":"2014","journal-title":"Circulation"},{"issue":"9","key":"zoi231404r50","doi-asserted-by":"publisher","first-page":"689","DOI":"10.7326\/0003-4819-132-9-200005020-00002","article-title":"Postmenopausal hormone therapy increases risk for venous thromboembolic disease. The Heart and Estrogen\/progestin Replacement Study.","volume":"132","author":"Grady","year":"2000","journal-title":"Ann Intern Med"},{"issue":"13","key":"zoi231404r51","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.1056\/NEJMoa050613","article-title":"A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women.","volume":"352","author":"Ridker","year":"2005","journal-title":"N Engl J Med"},{"key":"zoi231404r35","unstructured":"US Census Bureau. Quick facts: United States. Accessed July 28, 2023. https:\/\/www.census.gov\/quickfacts\/fact\/table\/US\/PST045222"},{"key":"zoi231404r37","unstructured":"Merative. Overview Micromedex RED BOOK. Published . Accessed November 10, 2023. https:\/\/www.merative.com\/micromedex-training-center\/red-book"},{"key":"zoi231404r39","unstructured":"SAS. SAS\/STAT(R) 9.22 user\u2019s guide. Updated June 22, 2010. Accessed November 10, 2023. https:\/\/support.sas.com\/documentation\/cdl\/en\/statug\/63347\/HTML\/default\/viewer.htm#statug_logistic_sect004.htm"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2812959\/davis_2023_oi_231404_1711468264.98962.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T11:00:35Z","timestamp":1711710035000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2812959"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,15]]},"references-count":51,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.48213","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2023.05.20.23290202","asserted-by":"object"}]},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,15]]}}}