Hormone Therapy and Blood Pressure in Postmenopausal Women

Abstract

Blood pressure increases in many women after menopause. Ovarian hormones, particularly estrogen, may be responsible, at least in part, for the lower blood pressure in premenopausal women. However, the mechanisms responsible for the increase in blood pressure in women after menopause are not yet fully known. In this article, we focused on estrogens and reviewed the effects of estrogen on the clinic blood pressure in women. Oral high-dose conjugated equine estrogen (CEE) administration and oral contraceptive use have been reported to increase the blood pressure in women. On the other hand, although oral common- and low-dose CEE administration had little effect on the blood pressure in younger postmenopausal women, oral common-dose CEE administration produced a slight increase of the blood pressure in older postmenopausal women with or without an established coronary heart disease. Transdermal 17β-estradiol had either no effect or produced a slight decrease in blood pressure in postmenopausal women. Raloxifene had no effect on blood pressure in postmenopausal women. In addition, concomitant administration of progestogens had little additional effect on the blood pressure in women receiving estrogen therapy. Oral high dose of CEE administration and oral contraceptive administration to post- and premenopausal women, respectively, and oral common-dose CEE administration to older postmenopausal women with or without established coronary heart disease should call for caution, particularly in individuals with uncontrolled hypertension. Further large, long-term, controlled, randomized studies are needed to confirm these findings.