Cardiovascular effects of 6 months of hormone replacement therapy versus placebo: Differences associated with years since menopause

Objective: In response to post-Women's Health Initiative dialog regarding individualized hormone replacement therapy (HRT), this study evaluates cardiovascular and neuroendocrine effects of HRT versus placebo in postmenopausal women grouped according to time since menopause. Study design: Resting and stress blood pressure (BP), hemodynamic, plasma catecholamine, and cholesterol levels were obtained in 69 women randomly assigned to placebo or active HRT in a 6-month double-blind study. Analyses evaluated if treatment effects differed among those postmenopausal less than 5 years versus 5 years or more. Results: Compared with the placebo-treated and HRT/≥ 5 groups, the HRT/<5 group showed reduced BP (P < .0007) and trends toward reduced vascular resistance and norepinephrine (P < .07). HRT/≥ 5 group generally did not differ from placebo. Conclusion: Reduced BP and sympathetic tone are evident in some HRT users, with diminishing benefit after the initial postmenopausal years. Time since menopause may be an important consideration in making individualized patient treatment decisions.