MENOPAUSAL HORMONE THERAPY AND HYPERTENSION

There is a recent study, out in the online journal of PLoS ONE, which studied the effects of Menopausal Hormone Therapy ( MHT ) or what we called here Hormone Replacement Therapy ( HRT ) on hypertension. The lead author, Dr Christine Chiu, and colleagues from the University of West Sydney, studied the effects of MHT on hypertension, by looking at the Australian 45 and Up study cohort. The mean age in the cohort was 63yrs. All in the cohort did not have hypertension to start. Some were on the Pill prior but the majority was not. They interviewed the cohort ( so this is an observational study ), and asked who was on the MHT and for how long.
They found that hypertension was more common in those on the MHT and that the duration of taking the MHT also correlated to the risk of hypertension.
Previously, studies were trying to establish the relationship of MHT / HRT and CAD risk and heart attacks. These came out with mixed results, although many tended to show a relationship between MHT and CAD risk.
This study has shown ( although it is only an observational study ), a good co-relation between taking the MHT and hypertension and also the duration of MHT with risk of hypertension.
The take home message should be that patients put on MHT should be closely monitored for onset of hypertension and perhaps some attention should be paid to how long to put them on. Obviously the shorter the better.
As to the reason why, there are many possibilities. I suppose the most obvious would be salt and water retention with MHT. There is little evidence to suggest that MHT affects the RAAS of SNS systems. This study also did not look into the types of MHT used. Perhaps some are safer then others? Anyway ....................
Avoid the Pill if you can. If you cannot, take as short a duration as possible.