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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.


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.