Arq. Bras. Cardiol. 2022; 118(5): 905-913

Hormone therapy and Hypertension in Postmenopausal Women: Results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Luana Ferreira-Campos , Ligia Gabrielli, Maria da Conceição Chagas Almeida, Estela Maria Leão Aquino, Sheila Maria Alvim Matos, Rosane Harter Griep, Roque Aras

DOI: 10.36660/abc.20210218

This Original Article is referred by the Short Editorial "Overcoming Women’s Lifelong Hormonal Rollercoaster: A Turning Point for Cardiovascular Prevention".

Abstract

Background

Hypertension is a major risk factor for cardiovascular morbidity and mortality in post-menopausal women. Although menopausal hormone therapy (MHT) is a very effective treatment for vasomotor symptoms during this period, the influence of this therapy on blood pressure is not yet clear.

Objective

To evaluate the relationship between the use of MHT and hypertension in participants of the ELSA-Brasil.

Methods

A cross-sectional study using the baseline ELSA-Brasil data in a cohort of 2,138 women who had experienced natural menopause. This study analyzed hypertension, defined as arterial pressure ≥140/90 mmHg or previous antihypertensive use, and use of MHT, with participants being classified into never, past, and current users. Associations were assessed using an adjusted logistic regression model, with statistical significance set at p<0.05.

Results

Overall, 1,492 women (69.8%) had never used MHT, 457 (21.4%) had used it in the past, and 189 (8.8%) were current users. The use of MHT was more common in women who had a body mass index (BMI) <25 kg/m²and triglyceride levels <150 mg/dl, and who were physically less inactive, non-smokers, and non-diabetics. Current MHT users were less likely to have hypertension (OR=0.59; 95% CI: 0.41-0.85) compared to those who had never used MHT. In most cases, MHT was started at or before 59 years of age, within 10 years of becoming menopausal, and its use lasted for up to five years.

Conclusion

Current MHT use was not related to hypertension, particularly in healthy women and in those under 60 years of age.