Cardiovascular Risk of Hormone Therapy May Depend on Age
As women will testify, hot flashes and night sweats (vasomotor symptoms, or VMS) are common around menopause. Hormone therapy (HT) is the most effective treatment for VMS, but is commonly avoided due to concerns about cardiovascular safety. Now, an analysis of two large clinical trials of postmenopausal women with VMS has helped to clarify both the efficacy and safety of HT for VMS. The women were divided into three age groups (50–59, 60–69, 70–79). The researchers found that estrogen alone was effective in reducing VMS in 41% in all age groups, but the effectiveness of estrogen plus progestin waned as age rose. HT in women ages 50–59 and 60-69 did not appear to significantly increase cardiovascular risk. In women ages 70–79, however, both estrogen alone and estrogen plus progestin increased cardiovascular risk. “The findings support guideline recommendations for treatment of VMS with HT in women ages 50–59 years, caution if initiating HT in women ages 60–69 years and avoidance of HT in women 70 years and older,” the authors concluded (JAMA Internal Medicine, online Sept. 15, 2025).
