[Hypertension and menopausal hormone therapy].

Area of Science:

• Cardiovascular Health
• Endocrinology
• Women's Health

Background:

• Menopausal hormone therapy (HT) use is debated in women with hypertension due to potential cardiovascular risks.
• Previous studies on oral HT raised concerns about increased cardiovascular events and breast cancer.
• The optimal timing and patient profile for initiating HT remain critical considerations.

Purpose of the Study:

• To evaluate the safety and efficacy of menopausal hormone therapy (HT) in women with hypertension.
• To review recent scientific literature on HT and its impact on blood pressure and cardiovascular outcomes.
• To provide guidance on prescribing HT for hypertensive women experiencing menopausal symptoms.

Main Methods:

• A comprehensive review of recent scientific literature was conducted by experts from the French Society of Hypertension.
• Analysis focused on randomized trials and observational studies concerning oral and transdermal HT.
• Cardiovascular risk factors, intervention timing, and age-related effects were assessed.

Main Results:

• Oral HT may be associated with a slight increase in blood pressure.
• Transdermal HT appears to be a safer route of administration.
• Initiating HT within 10 years of menopause and at a younger age may reduce cardiovascular risks and potentially decrease coronary events.

Conclusions:

• Prescribing HT for hypertensive women with significant menopausal symptoms necessitates a thorough cardiovascular risk assessment.
• The choice of HT route is crucial, with a preference for transdermal administration when feasible.
• An algorithm for prescription assistance is proposed, stratifying cardiovascular risk and favoring transdermal HT.