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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2005.071332v1 96/7/1219    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via ISI Web of Science (4) Citing Articles via Google Scholar Google Scholar Articles by Mishra, G. Articles by Kuh, D. Search for Related Content PubMed PubMed Citation Articles by Mishra, G. Articles by Kuh, D. Related Collections Media Health Education Public Health Practice Socioeconomic Factors Women's Health Cardiovascular Disease

Gita Mishra, PhD, Helen Kok, PhD, Russell Ecob, MSc, Rachel Cooper, MSc, Rebecca Hardy, PhD and Diana Kuh, PhD

Gita Mishra, Rachel Cooper, Rebecca Hardy, and Diana Kuh are with the MRC National Survey of Health and Development, Department of Epidemiology and Public Health, Royal Free and University College Medical School, London, England. At the time of the study, Helen Kok was with the Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands. Russell Ecob is with the MRC Hearing and Communications Research Group, University of Manchester, UK.

Correspondence: Requests for reprints should be sent to Professor Diana Kuh, MRC National Survey of Health and Development, Department of Epidemiology and Public Health, Royal Free and University College London Medical School, Gower Street Campus, 1–19 Torrington Place, London WC1E 6BT (e-mail: d.kuh{at}nshd.mrc.ac.uk).

Objectives. We examined the cessation of hormone replacement therapy (HRT) among British women, by educational level, social class, and cardiovascular risk factors, at the time of publicity about 2 clinical trials of HRT that were halted after adverse findings.

Methods. A total of 1387 women aged 57 years reported their monthly HRT use between January 2002 and February 2003. A succession of regression-based time-series models were fitted to detect changes in the proportion of HRT users stratified by education level, social class, hypertension, and obesity.

Results. The overall percentage of HRT users declined from 31% in January 2002 to less than 26% by February 2003. Changes in trends of HRT use were first detected in June 2002 (for women with advanced secondary educational qualification or higher) and in July 2002 (for all other groups). The rate of decline was greatest for women with no formal educational qualifications, from the manual social class, or who were hypertensive or obese.

Conclusions. These decreases coincided with the announced cessation of a large US clinical trial of HRT. This publicity may have had a differential influence on the immediate decline in HRT use by various groups of British women.