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Menopausal Hormone Therapy Associated With an Increased Risk of Incident Hypertension
April 21, 2021

By Erika Powers

VIRTUAL -- April 21, 2021 -- Use of hormone therapy among menopausal women appears to be associated with an increased risk of incident hypertension, especially when using oral oestrogen and pregnane and norpregnane derivative in case of combined treatment, according to a study presented at the Virtual 2021 Joint Meeting of the European Society of Hypertension (ESH) and the International Society of Hypertension (ISH).

“Although menopausal hormone therapy remains the most efficacious treatment for vasomotor symptoms of menopause, its effects on the development of arterial hypertension remain unclear,” said Madika, Anne-Laure, MD, Université de Lille, Lille, France.

To further clarify, the researchers analysed data from the E3N cohort study, a French prospective population-based study initiated in 1990 of 98,995 women, of which 49,905 had complete information on the use or nonuse of hormone therapy for menopause. Of the women, 32,183 (64.5%) reported ever using hormone therapy for menopause.

After a mean follow-up time of 10.6 years, there were 10,173 cases of hypertension. Compared with women who never used hormone therapy, those who ever used it had an increased risk of incident hypertension (adjusted hazard ratio [aHR] = 1.07; 95% confidence interval [CI], 1.02-1.12) after adjustment for body mass index and other potential confounders.

When formulation was taken into account, oral oestrogen (aHR = 1.09; 95% CI, 1.04-1.14) was associated with an increased risk of hypertension, but transdermal oestrogen use was not (aHR = 1.03; 95% CI, 0.99-1.07).

Regarding the impact of concomitant progestogens, pregnane and norpregnane derivatives were significantly associated with hypertension risk (HR = 1.12; 95% CI, 1.06-1.19 and HR = 1.06; 95% CI, 1.01-1.13, respectively).

“Use of menopausal hormone therapy was associated with an increased risk of incident hypertension, especially when using oral estrogen and pregnane and norpregnane derivative in case of combined treatment,” said Dr. Anne-Laure. ““Surveillance of blood pressure should be added to the medical surveillance of menopausal women who are hormone therapy users.”

[Presentation title: Menopausal Hormone Therapy and Risk of Incident Hypertension: Impact of the Route of Estrogen Administration and Progestogens in the E3N Cohort. Late-Breaking Abstracts]