A recent study published in the peer-reviewed American Heart Association journal, Hypertension indicates that women aged 45 years and above who undergo estrogen hormone therapy in oral form have a higher likelihood of developing high blood pressure compared to those who utilize transdermal (topical) or vaginal formulations.
Reduced progesterone and estrogen production increases heart disease risk
The American Heart Association indicates that the decrease in progesterone and estrogen production in women after menopause may raise the risk of cardiovascular diseases, including heart failure. Hormone therapy is often prescribed to alleviate menopausal symptoms, as part of gender-affirming care, and for contraception.
Previous studies have suggested that certain hormone therapies can potentially reduce the risk of cardiovascular disease in women under 60 years old or within ten years of menopause. However, the impact of different hormone therapies on blood pressure in menopausal women and their potential effects remain uncertain, as highlighted by the authors of this study.
Lead study author Cindy Kaleng, a Ph.D. student at the University of Calgary, said that estrogen ingested orally undergoes metabolism in the liver, which is associated with factors contributing to higher blood pressure. Kalenga added that postmenopausal women tend to be at increased risk of blood pressure relative to premenopausal women. According to past studies, different kinds of hormone therapy have been linked to increase cardiovascular disease risk.
Estrogen therapy increases cardiovascular risk by 14%
According to study findings, women taking estrogen therapy in the form of a pill had a 14% increased risk of having high blood pressure relative to those having transdermal estrogen. Additionally, oral estrogen therapy had a 195 increased blood pressure risk relative to those on vaginal estrogen creams. On the other hand, conjugated equine estrogen increased the risk of high blood pressure by 8%. The authors observed that a longer duration of estrogen hormone therapy or a higher dosage was linked to an increased risk of high blood pressure. Kalenga, one of the researchers, stated that the findings imply that menopausal women who opt for hormone therapy should consider various types of estrogen that potentially carry lower cardiovascular risks.
