The effect of hormone replacement therapy on cardiac structure and function

  • PLoS One

  • from Dawn O'Shea
  • UK Medical News
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Hormone replacement therapy (HRT) appears to significantly reduce left ventricular (LV) and left atrial (LA) chamber volumes, suggesting a positive effect on heart health, according to a new study led by Queen Mary University of London.

The study, published in PLoS One, found HRT use was not associated with adverse, subclinical changes in cardiac structure and function. In fact, significantly smaller LV and LA chamber volumes were observed in women using HRT – characteristics that have been linked to favourable cardiovascular outcomes.

The effect of HRT on cardiovascular health in post-menopausal women remains controversial since the Women’s Health Initiative and Heart and Estrogen/Progestin Replacement Study studies cast doubt on its cardioprotective effects. This new study used data from the UK Biobank to identify post-menopausal women who had never used HRT and those who had used HRT for at least three years, who had undergone cardiovascular MRI (CMRI) and were free of known cardiovascular disease.

Of 1604 post-menopausal women, 513 (32%) had used HRT for at least 3 years. Median duration of HRT was 8 years. HRT use was found to be associated with significantly lower LV end-diastolic volume (122.8 mL vs 119.8 mL; effect size=−2.4%; 95% CI, −4.2% to −0.5%; P=.013) and LA maximal volume (60.2 mL vs 57.5 mL; effect size=−4.5%; 95% CI, −7.8% to −1.0%; P=.012), compared with women who had never used HRT. There was no significant difference in LV mass.

HRT use significantly modified the effect between age and CMRI parameters. HRT users had greater reductions in LV end-diastolic volume, LV end-systolic volume and LA maximal volume with advancing age.

The authors say the findings represent a novel approach to examining HRT’s effect on the cardiovascular system. Future work will focus on the link between HRT use and CMRI parameters, to cardiovascular outcomes.