Does Hormone Therapy Increase Blood Pressure in Postmenopausal Women with Hypertension?
BACKGROUND AND PURPOSE:
Jiang et a. (Menopause, 2023) assessed the effect of hormone therapy (HT) on blood pressure control in postmenopausal women with hypertension
Secondary analysis of double-blinded, randomized, placebo-controlled studies
Women’s Health Initiative (WHI)-HT clinical trials
Women 50 to 79 years with hypertension at baseline
Conjugated equine estrogens (CEE, 0.625 mg/d) OR
CEE + medroxyprogesterone acetate (MPA, 2.5 mg/d)
Blood pressure was measured at baseline and up to 10 annual follow-up visits during the planned study phase
Hypertension: Reported as ever taking pills for hypertension or were taking antihypertensive medication
Antihypertensive medications were inventoried at baseline and years 1, 3, 6, and 9 during the study | Self-reported during extended follow-up at median 13 and 16 years after randomization
Intervention effect was estimated through year 6
9332 postmenopausal women with hypertension
Compared with placebo, CEE-alone had significantly higher systolic blood pressure (SBP) during
Mean 0.9 mm Hg (95% CI, 0.2 to 1.5); P=0.02
Mean 0.8 mm Hg (95% CI, 0.1 to 1.4): P=0.02
CEE + MPA also had higher systolic BP during
Mean 1.8 mm Hg (95% CI, 1.2 to 2.5); P<0.001
Mean 1.6 mm Hg (95% CI 1.0 to 2.3); P<0.001
Mean number of antihypertensive medications taken at each follow-up visit did not differ between randomization groups during the intervention or long-term extended follow-up of 16 years
For postmenopausal women with hypertension, receiving HT was associated with slightly higher blood pressure during both intervention and the follow-up phase
Increase in blood pressure did not lead to increased antihypertensive medication use over time
The authors state
Taken together, these results indicate that the HT effect on blood pressure control may not be clinically significant or warrant additional antihypertensive medications among postmenopausal HT users on antihypertensive drugs
Further research is needed to determine whether the effect of HT on SBP and hypertension mediated the effect of HT on risk of cardiovascular disease in postmenopausal women
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
NOT ENOUGH CME HOURS
It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan