Discontinuation of lower doses of menopausal hormone therapy (MHT) did not alter the expected trajectory of changes in carotid artery intima-media thickness (CIMT), according to a study published in The Journal of The North American Menopause Society.
In a follow-up to the Kronos Early Estrogen Prevention Study (KEEPS; ClinicalTrials.gov Identifier: NCT00154180, researchers assessed the impact of discontinuation of lower doses of MHT on CIMT over a 7-year period. Participants (n=76) included in the initial study were white, aged between 42 and 59 years (median, 53.3 years), were within 5 to 36 months (median, 1.6 years) of their last menses, and were in good cardiovascular health. Patients received either oral conjugated estrogens (Premarin®, 0.45 mg/d), transdermal estradiol (Climara®, 50 µg/d), or placebo. Patients underwent medical examination that included evaluation of CIMT by B-mode ultrasonography. CMIT was measured annually every 4 years during the study and for 3 years during the follow-up period.
The average increase in CIMT across all 3 groups was 4.1% at year 4 and 9.1% at year 7, reflecting a 5.4% increase from year 4 to 7. The rate of increase during the post-treatment period was greater for the overall group, as well as for those receiving oral conjugated estrogen, as compared with the rate of increase seen during the treatment phase. No significant differences in CIMT increase between the treatment and post-treatment periods were seen in either the placebo or transdermal estradiol groups.
“Cessation of lower dosages of MHT such as those used for 4 years in the KEEPS study did not accelerate changes in CIMT over a 3-year period,” the authors concluded.
Miller VM, Hodis HN, Lahr BD, Bailey KR, Jayachandran M. Changes in carotid artery intima-media thickness 3 years after cessation of menopausal hormone therapy: follow-up from the Kronos Early Estrogen Prevention Study [published online July 16, 2018]. Menopause. doi: 10.1097/GME.0000000000001167