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Is Menopausal Hormone Therapy to Blame for High Blood Pressure?

According to a study, women taking menopausal hormone treatment (MHT) are at risk of developing hypertension, especially those taking oral estrogen plus a progestogen such pregnane and norpregnane derivatives.

Is Menopausal Hormone Therapy to Blame for High Blood Pressure?
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The researchers used data from the Etude Epidémiologique de Femmes de la Mutuelle Générale de l'Education (E3N), a French prospective population-based study, to investigate the links between different MHT formulations and incident hypertension in women.

Of the 98,995 women who took part in E3N, 49,905 (mean age 54.2 years) had complete information on MHT use and were hypertension-free at baseline, therefore they were included in the study.

MHT was reported by 32,183 women (64.5%). During an average follow-up of 10.6 years, 10,173 of these women experienced incident hypertension. Women who had ever used MHT had a modest but significantly increased risk of incident hypertension (adjusted hazard ratio [HR], 1.07, 95 percent confidence interval [CI], 1.02–1.12) when compared to nonusers, according to a multivariable Cox analysis (adjusted hazard ratio [HR], 1.07, 95 percent confidence interval [CI], 1.02–1.12).

In MHT formulations, oral estrogen use was associated with an increased risk (adjusted HR, 1.09, 95 percent CI, 1.04–1.14 and adjusted HR, 1.03, 95 percent CI, 0.99–1.07, respectively), though the risk estimations were not statistically different (p=0.09 for homogeneity).

Pregnane and norpregnane derivatives were both highly linked with hypertension risk (adjusted HR, 1.12, 95 percent CI, 1.06–1.13 and adjusted HR, 1.06, 95 percent CI, 1.01–1.13, respectively) when concomitant progestogens were considered.

The results highlight the need of blood pressure monitoring in MHT users.


Source: Menopause 2021;doi:10.1097/GME.0000000000001839

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