Menopausal hormone therapy a culprit in hypertension?

Women on menopausal hormone therapy (MHT) are at risk of developing hypertension, particularly those using oral oestrogen plus a progestogen such as pregnane and norpregnane derivatives, according to a study.

The study used data from the French prospective population-based study, Etude Epidémiologique de femmes de la Mutuelle Générale de l’Education (E3N), to explore relationships between different formulations of MHT and incident hypertension among women.

Out of the 98,995 women who participated in E3N, 49,905 (mean age 54.2 years) had complete information on the use of MHT and were hypertension-free at baseline and were included in the analysis.

There were 32,183 women (64.5 percent) who reported ever using MHT. Of these, 10,173 women developed incident hypertension over an average follow-up of 10.6 years. Multivariable Cox analysis showed that compared with nonusers, women who 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).

Looking at MHT formulations, oral but not transdermal oestrogen use conferred a risk increase (adjusted HR, 1.09, 95 percent CI, 1.04–1.14 and adjusted HR, 1.03, 95 percent CI, 0.99–1.07, respectively), although the risk estimates did not differ significantly (p=0.09 for homogeneity).

Considering the role of concomitant progestogens, pregnane and norpregnane derivatives were both strongly associated with hypertension risk (adjusted HR, 1.12, 95 percent CI, 1.06–1.19 and adjusted HR, 1.06, 95 percent CI, 1.01–1.13, respectively).

The findings highlight the importance of monitoring blood pressure among MHT users.