Menopausal Hormone Therapy and Cardiovascular Risk in Midlife Women With Vasomotor Symptoms
JAMA Internal Medicine 10.1001/jamainternmed.2026.2922September 08, 2026 at 11:00 AM EDT
The presented results are pooled from all target trials and found that MHT initiation during perimenopause or recently postmenopausal women with vasomotor symptoms was estimated to reduce CVD risk by 22%. Benefits were more pronounced in Black women and women who initiated MHT within 10 years of menopause onset. However, all estimates warrant caution given the potential for residual confounding. Given the inconsistency of the cardiovascular benefits and the need to consider overall risk-benefit balance, these findings should not be used to support MHT for CVD prevention.
In Short: Target trial emulation suggested lower estimated cardiovascular disease risk with menopausal hormone therapy initiation in midlife women with vasomotor symptoms, with stronger estimated associations among women initiating therapy within 10 years of menopause onset and among Black women.
Related: This Original Investigation has an accompanying commentary.
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