Hormone therapy cuts CVD risk in women

Initiation of hormone therapy during menopause or in recently postmenopausal women with vasomotor symptoms helps lower the risk of cardiovascular disease (CVD), according to a study.

Researchers used data from the Study of Women’s Health Across the Nation to emulate a sequence of target trials. They included a total of 2,737 women who reported any vasomotor symptoms.

Menopausal hormone therapy use, including that of systemic oestrogen with or without progestogens, was determined. CVD outcomes, including myocardial infarction, stroke, heart failure, and revascularization, were self-reported. CVD-related death was ascertained using death certificates.

Of the women, 755 (mean age 53.7 years) initiated menopausal hormone therapy (MHT) over the 20-year follow-up period, during which 224 fatal and nonfatal CVD events were documented.

Compared with noninitiation, MHT initiation was associated with a 22-percent reduction in the risk of CVD events (adjusted hazard ratio [aHR], 0.78, 95 percent confidence interval [CI], 0.62–0.98). The beneficial effect of MHT on CVD events was more pronounced among Black women (aHR, 0.51, 95 percent CI, 0.33–0.81).

No clear effects were observed among women initiating MHT more than 10 years from the onset of menopause and among White women or women of other races.

The researchers acknowledged that the findings should not be used to support MHT for CVD prevention, given the inconsistency of the cardiovascular benefits and the need to consider overall risk-benefit balance.