RE: HRT increases BP

[Guest guest]

and rember the highly prone tendency toward cancer as well. skSunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com To: oregondcs From: twogems@...Date: Wed, 18 Jul 2012 14:45:54 -0700Subject: HRT increases BP

Docs:

One thing leads to another.

Lyndon McGill, D.C.

EvolvHealth Wellness Advisory Council Member

Salem, Oregon

www.SalemSpineClinic.com

www.EvolvingDaily.com

HRT Ups BP; Risk of Hypertension Higher With Longer Duration of

Use

Nainggolan

July 13, 2012 (Penrith, Australia) — A large new study of

over 40 000 postmenopausal women has found that use of hormone

replacement therapy (HRT) is associated with an increased risk of

high blood pressure [1]. The results also show, for the first

time, that the risk of hypertension rises with longer duration of

HRT use, say Dr L Chiu (University of Western

Sydney, Penrith, Australia) and colleagues in PLoS One.

And importantly, "the association between using HRT and high

blood pressure was more prominent for younger postmenopausal

women, aged 45–55 years," senior author Dr Joanne M Lind

(University of Western Sydney) told heartwire .

"By the time women reached their 70s, the impact was not

significant anymore."

We

recommend that doctors take into consideration the fact that

HRT could increase the odds of having high BP and if possible

minimize the length of time that women take it.

Lind notes that it is "still only an association, we don't know

the direct cause. But we do know that of the women who'd used HRT,

more of them had high BP compared with the women who'd never used

it. We recommend that doctors take into consideration the fact

that HRT could increase the odds of having high BP and if possible

minimize the length of time that women take it." She and her

fellow authors also recommend that BP should be closely monitored

both during and after use of hormone therapy, and that women be

made aware that hypertension is a possible risk of HRT use.

Risk of Hypertension Rose With HRT in Younger Women

Most of the studies conducted to date have focused on the risk of

myocardial infarction and stroke from HRT, and of those studies

that have investigated the relationship between HRT and blood

pressure, the findings have been largely inconsistent, Chiu and

colleagues state in their paper. Using data from the 45 and Up

Study of healthy aging, which Lind notes is the "largest of its

kind in the Southern hemisphere," they set out to ascertain the

association between HRT use and hypertension, and whether the

number of years spent taking HRT was associated with risk.

A total of 43 405 postmenopausal women, average age around 63

years, were included, all of whom had an intact uterus, had gone

through menopause, and had not started HRT and did not have

hypertension prior to menopause. Of the 12 443 women who had used

HRT (past or current), 20% self-reported having high BP compared

with 17% of the 30 962 women who had never used it.

In that

younger age group, any length of time they took HRT was

associated with higher odds [of hypertension that] . . . just

kept on increasing the longer a woman had taken it.

The researchers note they could not account for the different

types of HRT taken by women in the study, as that information was

not available.

After adjusting for demographic and lifestyle factors, odds

ratios for the association between HRT use and hypertension was

1.59 for those <56 years, 1.58 for those aged 56–61 years, and

1.26 for those aged 62–70 years. Women who had used HRT at any

time were first diagnosed with hypertension 2.8 years earlier than

women who had never used it.

"In that younger age group, any length of time they took HRT was

associated with higher odds [of hypertension], and those odds just

kept on increasing the longer a woman had taken it," Lind noted

adding, "no one has shown that before."

But as women got older, the association between HRT use and

hypertension diminished, she adds.

Longer Follow-Up Needed

Lind says some of the older studies that examined HRT and BP even

found a slight reduction in BP in women who taking such therapy

"but they haven't looked at the long-term effects," she says,

adding that this information is sorely needed.

"A clinical trial of HRT, which includes an extended period of

follow-up after cessation of treatment, is required to decipher

how HRT leads to higher odds of having high blood pressure. Such a

trial should initiate HRT close to menopause and only include

women who have never used HRT previously," she and her colleagues

conclude.

The authors report no conflicts of interest.

References

Chiu CL, Lujic S, Thornton C, et al. Menopausal hormone

therapy is associated with having high blood pressure in

postmenopausal women: observational cohort study. PLoS

ONE 2012;7:e40260. Available at: http://www.plosone.org.

Heartwire © 2012 Medscape, LLC