Grant: Op. Grant: NWHRI: Innovation Fund - Translational Research

Globally, cardiovascular disease is the leading cause of death in women, and more women have chronic kidney disease compared to men, highlighting the importance of studying sex-specific cardiovascular risk factors, such as exposure to estrogens. The population of postmenopausal women will reach over 1 billion globally by the year 2030. The hallmark of the menopausal transition is the presence of vasomotor symptoms such as hot flashes and/or night sweats, which are experienced by over 75% of women and may persist for over 7 years. Hormone therapy remains the most effective treatment for menopausal symptoms, but the decision to use hormone therapy is complex and requires individualized balancing of the risks and benefits. Previous studies have indicated an increase in adverse cardiovascular events with hormone therapy use, though how a person takes estrogen hormones (by mouth or by another route, such as through the skin using a patch or other) may change this risk. The goal of the proposed program of research is to investigate the association between how a person takes estrogen in menopausal hormone therapy (by mouth or by patch) and cardiovascular and kidney health. We hypothesize that estrogen taken by mouth, compared to estrogen not taken by mouth (e.g., patch), in people who use menopausal hormone therapy will be associated with increased blood pressure and other markers of cardiovascular and kidney risk. How stiff a person's blood vessels are is a marker of future risk of heart attack. We will measure and compare the blood pressure, blood vessel stiffness and kidney blood flow in healthy menopausal individuals using hormone therapy by mouth to that of individuals using patch hormone therapy and age-matched individuals not using any menopausal hormone therapy. This research program will advance our understanding of how estrogens impact cardiovascular and kidney health and address the broader understanding of women's health in the menopausal years.