Abstract

BackgroundThe relationship between menopausal hormone therapy (MHT) and cardiovascular risk remains controversial, with a number of studies advocating the use of MHT in reducing risk of cardiovascular diseases, while others have shown it to increase risk. The aim of this study was to determine the association between menopausal hormone therapy and high blood pressure.Methods and FindingsA total of 43,405 postmenopausal women were included in the study. Baseline data for these women were sourced from the 45 and Up Study, Australia, a large scale study of healthy ageing. These women reported being postmenopausal, having an intact uterus, and had not been diagnosed with high blood pressure prior to menopause. Odds ratios for the association between MHT use and having high blood pressure were estimated using logistic regression, stratified by age (<56 years, 56–61 years, 62–70 years and over 71 years) and adjusted for demographic and lifestyle factors. MHT use was associated with higher odds of having high blood pressure: past menopausal hormone therapy use: <56 years (adjusted odds ratio 1.59, 99% confidence interval 1.15 to 2.20); 56–61 years (1.58, 1.31 to 1.90); 62–70 years (1.26, 1.10 to 1.44). Increased duration of hormone use was associated with higher odds of having high blood pressure, with the effect of hormone therapy use diminishing with increasing age.ConclusionsMenopausal hormone therapy use is associated with significantly higher odds of having high blood pressure, and the odds increase with increased duration of use. High blood pressure should be conveyed as a health risk for people considering MHT use.

Highlights

  • Menopausal hormone therapy (MHT) is primarily prescribed for the treatment of perimenopausal symptoms

  • Menopausal hormone therapy use is associated with significantly higher odds of having high blood pressure, and the odds increase with increased duration of use

  • High blood pressure should be conveyed as a health risk for people considering menopausal hormone therapy (MHT) use

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Summary

Introduction

Menopausal hormone therapy (MHT) is primarily prescribed for the treatment of perimenopausal symptoms. [1] Clinical trials later suggested MHT did not reduce the risk of coronary heart disease and was of no benefit to cardiac health. Hypertension, or high blood pressure, is considered a major risk factor for cardiovascular morbidity and mortality in postmenopausal women. Studies in hypertensive postmenopausal women have either shown a slight decrease in blood pressure with MHT use, [8] or no effect on blood pressure with MHT use. The relationship between menopausal hormone therapy (MHT) and cardiovascular risk remains controversial, with a number of studies advocating the use of MHT in reducing risk of cardiovascular diseases, while others have shown it to increase risk. The aim of this study was to determine the association between menopausal hormone therapy and high blood pressure

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