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Aortic hemodynamics in postmenopausal women following cessation of hormone therapy
Ronée E Harvey1,2, Maja C Johnson2, Sushant M Ranadive2
1Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota.
Insights
Menopausal hormone therapy had no lasting impact on central aortic blood pressure or pulse wave characteristics in postmenopausal women three years after treatment cessation. Cardiovascular health markers remained unchanged across different therapy types and placebo groups.
Area of Science:
- Cardiovascular Health
- Menopausal Hormone Therapy
- Vascular Function
Background:
- Central aortic blood pressure and pulse wave characteristics are key indicators of cardiovascular health and mortality risk.
- Previous research has explored aortic hemodynamics during menopausal hormone therapy (MHT) use, but long-term effects after cessation are not well-defined.
- Understanding these vascular changes post-MHT is crucial for assessing long-term cardiovascular risk in postmenopausal women.
Purpose of the Study:
- To investigate and define aortic pulse wave characteristics in postmenopausal women after they discontinued menopausal hormone therapy.
- To compare central hemodynamics in women with a history of MHT use versus those who never used MHT.
Main Methods:
- Pulse wave analysis was performed on 67 postmenopausal women from the Kronos Early Estrogen Prevention Study (KEEPS).
- Participants were assessed 3 years after a 4-year treatment period involving oral conjugated equine estrogen, transdermal 17β-estradiol (both with micronized progesterone), or placebo.
- Demographic data, including age and body mass index, were collected and compared across groups.
Main Results:
- No significant differences were observed in median age (60 years) or body mass index (27 kg/m²) across the prior treatment groups.
- Central aortic systolic (115 mm Hg) and diastolic (76 mm Hg) blood pressures did not differ among the groups.
- Aortic augmentation index (median 33%) also showed no significant variations between women who had used MHT and those in the placebo group.
Conclusions:
- The specific doses and formulations of MHT used in the KEEPS trial did not result in long-term alterations to central vascular function.
- Three years after treatment cessation, key measures of central hemodynamics were comparable across MHT and placebo groups.
- These findings suggest a lack of persistent impact of the studied MHT regimens on aortic pulse wave characteristics in postmenopausal women.
Abstract:
Central (aortic) blood pressure and aortic pulse wave characteristics are measures of cardiovascular health, predictive of cardiovascular mortality. Previous studies have compared aortic hemodynamics in women who do and do not take menopausal hormone therapy, but characteristics of these parameters following cessation of treatment have not been defined. Therefore, the purpose of this study was to define aortic pulse wave characteristics in postmenopausal women with and without a history of menopausal hormone therapy use. Pulse wave analysis was conducted on 67 women who had participated in the randomized, double-blind, placebo-controlled Kronos Early Estrogen Prevention Study (KEEPS), 3 years subsequent to the four-year treatment period. Treatment was oral conjugated equine estrogen (0.45 mg/day; n = 18); transdermal 17β-estradiol (50 μg/day; n = 23) each with oral micronized progesterone (Prometrium 200 mg); and placebo pills and patch (n = 26). At post-treatment, median age (60 years) and body mass index (27 kg/m2) did not differ across prior treatment assignment. Aortic blood pressures (median systolic 115 mm Hg and diastolic 76 mm Hg) and augmentation index (median 33%) did not differ among women across prior treatment assignment. These results suggest that these doses and formulations of menopausal hormone therapy had no long-term effects on central vascular function 3 years after cessation of treatment.
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