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Effect of Hormone Therapy on Incident Hypertension

Menopause; ePub 2018 Jan 29; Swica, et al

There is an increased risk of hypertension in older postmenopausal women administered conjugated equine estrogens (CEE; 0.625 mg/d) orally, with or without CEE plus medroxyprogesterone acetate (MPA), a recent study found. 27,347 postmenopausal women aged 50 to 79 years from 40 US centers were enrolled in the study, which also included a subsample analysis of 18,015 women who did not report hypertension at baseline and were not taking antihypertensive medication. Women with an intact uterus received CEE (0.625 mg/d) plus MPA (2.5 mg/d) (n=5,994) or placebo (n=5,679). Women with prior hysterectomy received CEE alone (n=3,108) or placebo (n=3,234). Among the findings:

  • The rate of incident hypertension was 18% higher for intervention than for placebo (CEE: HR, 1.18; CEE plus MPA: HR, 1.18) during the CEE and CEE plus MPA intervention phase.
  • This effect dissipated postintervention in both trials.

Citation:

Swica Y, Warren MP, Manson JE, et al. Effects of oral conjugated equine estrogens with or without medroxyprogesterone acetate on incident hypertension in the Women’s Health Initiative hormone therapy trials. [Published online ahead of print January 29, 2018]. Menopause. doi: 10.1097/GME.0000000000001067.