Atherosclerosis: The Benefits of Hormone Therapy in Menopausal Women

Hormone therapy could have a delaying effect on the formation of atherosclerosis and resulting heart disease.

Atherosclerosis

According to the results of the Elite study (an early and late intervention trial with estradiol [a form of estrogen]), conducted between 2004 and 2013 by the University of Southern California and presented on September 28, 2020, at the Congress of the American Menopause Society, estrogen is a good preventive measure for heart disease, particularly the progression of atherosclerosis.

Atherosclerosis is a chronic inflammatory process most often involving blood vessels in the heart. The risk of cardiovascular disease in women increases rapidly after menopause and remains the leading cause of death in American women. The Elite study had already demonstrated the benefits of hormone therapy in reducing atherosclerosis progression. The current study adds to that knowledge. It identifies markers of inflammation that were altered by hormone therapy in the Elite study.

Estradiol is Protective in Women Approaching Menopause

As a reminder, during this study, 643 postmenopausal women received estradiol or a placebo orally. The researchers then measured the concentrations of 12 inflammatory biomarkers. They thus confirmed that estradiol does have a beneficial effect by significantly reducing the concentrations of numerous key biomarkers. These effects are more visible in women with 6 years past menopause than in women who had experienced menopause 10 years earlier.

“In the total sample, mean levels of E-selectin, ICAM-1, IFNγ, and IL-8 [all biomarkers of inflammation] during the trials were significantly lower in the hormone therapy group compared with placebo-treated women,” said senior study author Dr. Roksana Karim, a researcher at the University of Southern California Keck School of Medicine.

However, only E-selectin levels had decreased for women who received hormone therapy 10 or more years after menopause compared to those who received a placebo. “This study helps us better understand possible physiological mechanisms that may explain why hormone therapy slows the progression of heart disease in the early stages after menopause, but not in women who are further away from the menopausal transition,” said NAMS Medical Director Dr. Stephanie Faubion.

More research is needed to better understand how time since menopause affects the influence of hormone therapy on the risk of heart disease.