Study: Contemporary menopause hormone therapy shows no clear harm to heart health

A large Israeli study found that modern hormone therapy used to ease menopause symptoms was not associated with higher rates of heart disease, blood clots or premature death. The results could help guide conversations for women who start treatment in midlife and do not have a prior history of these conditions.

For people whose menopause symptoms interfere with daily life, more reliable information about treatment risks can be important. The study offers some reassurance for a carefully defined group, though individual choices still depend on medical history, symptoms and the specific therapy being considered.

The research drew on Clalit Health Services records and was led by Ronen Arbel, who is affiliated with Clalit and Sapir College. It is set to be presented at the American Heart Association’s Scientific Sessions, rather than appearing as a completed peer-reviewed journal article.

Researchers compared women ages 45 to 59 who began hormone replacement therapy with women who had seen a gynecologist but did not start treatment. The analysis covered more than 52,000 women and excluded those with a history of heart disease, blood clots or cancer.

The two groups were matched on several factors, including age, body mass index, blood pressure, cholesterol, diabetes, smoking and socioeconomic status. That matching was meant to make the comparison more meaningful, although it could not eliminate every difference between the patients.

Medical records were tracked for an average of 12 years, and in some cases for as long as 23 years. The outcomes included heart attack, stroke, other cardiovascular disease, blood clots and death before age 80.

Separate from hormone treatment, researchers are also developing AI-based blood tests designed to estimate longer-term heart disease risk.

The researchers said women who started hormone therapy had outcomes similar to those who did not. They also reported a similar overall pattern across different forms of treatment, including tablets, patches and gels.

These findings matter because hormone therapy is not a single treatment used by a single type of patient. Earlier studies often involved different preparations, doses or women who started treatment at older ages, so the context of each study remains important.

Even so, the new analysis cannot prove the therapies caused no rise in risk. Women prescribed hormones may differ from nonusers in exercise habits, diet, other illnesses or the severity of their menopause symptoms, and those factors were not fully captured.

The study also grouped women by their initial hormone treatment without fully following changes in formulation over time. As a result, it cannot offer a definitive comparison of the long-term risks of every individual product or treatment pattern.

The findings are still preliminary until full peer review is completed, and they should not be extended to women with different medical histories or used as a reason to begin hormones for heart protection. Their main value is adding evidence for a personalized discussion about symptom relief, possible benefits and potential harms.

For broader related reading, please see articles about Vitamin K May Help Protect Women from Heart Disease Risk, and Whole Fat Dairy Food May Benefit Your Heart Health Study Finds.

For more information, please see articles about Little Used Blood Test May Prevent Heart Attack and Stroke Better, and Quick Exercise Snacks Could Improve Your Heart Health.

Source: Clalit Health Services and Sapir College.