BACKGROUND AND PURPOSE: 

• Kim et al. (Menopause, 2021) investigated the association of menopausal hormone therapy (MHT) with cardiovascular diseases (CVDs) and type 2 diabetes among middle-aged postmenopausal women  

METHODS: 

• Retrospective cohort study  
  • Data derived from mandatory single-payer program used by entire Korean population 
• Population 
  • Postmenopausal women  
  • Reported menopause status from the cancer-screening program between 2006 and 2008  
  • Reported age at menopause onset of 40 to 69 years 
  • Had menopause period ≤1 year  
  • Exclusion: Previous diagnostic CVDs, type 2 diabetes, or other diseases associated with contraindication to MHT use (cancer, transient ischemic attack, and liver diseases) 
• Exposures 
  • Oral MHT: Classified as estrogen only, combined estrogen and progestogen, tibolone, and multitype 
• Study design 
  • Menopause status: Self-reported  
  • Time-dependent Cox regression modeling was used to evaluate the associations between MHT and the primary outcomes | Multiple potential confounding variables were adjusted for including age at menopause, preexisting comorbidities, socioeconomic status and lifestyle factors  
  • Subgroup analyses: Regimen type | Cumulative duration 
• Primary outcomes 
  • CVDs 
  • Type 2 diabetes 

RESULTS: 

• MHT users: 8013 women (13.8%) | MHT nonusers: 50,047 women (86.2%) 
• MHT category 
  • Combined EP: 24.5% 
  • Tibolone: 43.0% 
  • Estrogen-only: 6.8% 
• MHT was not significantly associated with CVDs or type 2 diabetes 
  • CVDs: HR 1.085 (95% CI, 0.899 to 1.310) 
  • Type 2 diabetes: HR 1.104 (95% CI, 0.998 to 1.221) 
• There were no differential effects observed for  
  • Regimen type 
  • Cumulative duration of treatment 
  • Years since menopause  

CONCLUSION: 

• MHT does not appear to have any effects on CVDs or type 2 diabetes in postmenopausal women 
• The authors state 

To the best of our knowledge, there have been no studies assessing the associations of MHT with CVDs following the current guidelines or algorithms for MHT 

Our results may suggest that the use of MHT for appropriate participants who have assessed the timing of initiation or baseline diseases can expect relief of menopausal symptoms by MHT without concerns about the risk of CVDs 

Learn More – Primary Sources: 

Effects of menopausal hormone therapy on cardiovascular diseases and type 2 diabetes in middle-aged postmenopausal women: analysis of the Korea National Health Insurance Service Database 

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