In a new study, researchers found for the first time that hormone replacement therapy affects the accumulation of heart fat, a new risk factor for heart disease in midlife women.
The finding reinforces the importance of tailoring hormone therapy to each woman, based on her individual risk factors for heart disease.
The research was conducted by a team from the University of Pittsburgh.
Menopause commonly comes with a host of challenges, including hot flashes, night sweats, vaginal dryness and increased risk of osteoporosis.
Hormone replacement therapy is a common treatment for these menopause-related symptoms.
Previous research has shown postmenopausal women with lower estrogen levels had more paracardial fat—meaning fat that accumulates outside the pericardium—and also higher rates of coronary artery calcification.
In the study, the team used data from 474 healthy women ages 42 through 58 enrolled in the Kronos Early Estrogen Prevention Study (KEEPS).
Participants enrolled between 2005 and 2008 and were followed for four years.
The team found that the formulation and delivery route of hormones mattered when it came to the types of fat women developed and whether those fat deposits translated to hardening of the arteries.
The transdermal estradiol patch compounded the harmful effects of paracardial fat on coronary artery calcification.
In contrast, women on the estrogen pill were less likely to see increases in heart fat in the epicardial space immediately surrounding the heart or worsening coronary artery calcification.
The finding shows a novel heart disease risk factor that’s specific to menopausal women also is affected by hormone therapy.
The researchers suggest doctors should not treat all menopause hormone therapy types the same.
They hope doctors will take these findings into account when treating healthy menopausal women with the drugs used in the study.
The lead author of the study is Samar El Khoudary, Ph.D., M.P.H., associate professor of epidemiology at Pitt Public Health.
The study is published in the Journal of the American Heart Association.
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