Menopausal hormone therapy does not play a major role in left ventricular hypertrophy

Left ventricular hypertrophy (LVH) is a precursor of morbidity and mortality in women. Use of menopausal hormone therapy (MHT) might be associated with decreased left ventricular mass (LVM) and lower risk of LVH, although results of previous observational and clinical studies are inconclusive. Therefore, we analyzed the association between MHT use and either LVM indexed to height(2.7) (LVMI) or LVH determined echocardiographically.

Data from women aged >or=45 years recruited for the population-based Study of Health in Pomerania were used for cross-sectional (n=975) and longitudinal (n=675; 361 women without LVH at baseline) analyses. Information on ever (past and current) and never use of MHT were obtained. Linear (LVMI) or logistic (LVH) regression analyses were performed while controlling for potential confounders.

Crude and age-adjusted analyses suggested an association between ever use of MHT and lower odds for LVH. This association was no longer significant in fully adjusted models. Compared to women who never used MHT, the odds ratios of LVH for ever MHT users were 0.97 [95%-confidence interval (95%-CI) 0.71-1.30] in cross-sectional and 0.70 (95%-CI 0.44-1.11) in longitudinal fully adjusted analyses. Similarly, results with an alternative classification of MHT use (never, past, and current) indicated no significant associations with LVH after full adjustment.

This study provides little evidence of an association between MHT use and LVH. Differences in lifestyle or health-related factors between never and MHT users could provide an explanation, in part, for the presumptive protective benefit of MHT on LVH.