Smoking and HRT

I know that oral contraceptives increase risk of complications in women older than 35 years who smoke, but what about HRT in these women?
—Carolyn M. Comer, APRN, BC, Elgin, S.C.

Though smoking is not listed as a contraindication for hormone therapy, it is a known protagonist of cardiovascular disease. Since long-term hormone therapy has now been found to have a generally deleterious effect on the cardiovascular system, it would be unwise to further complicate the picture. Women who have a clinical need for osteoporosis prevention and/or management with estrogen-containing hormone therapy should be aggressively encouraged to quit smoking.
—Sherril Sego, MSN, FNP (102-4)

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