Global Health Asia-Pacific Issue 3 | 2023 Issue 3 | 2023 | Page 20

Oral therapy for menopause raises risk of high blood pressure

Women should consider safer options

Menopause leads to the reduced production of hormones like oestrogen and progesterone , which may increase the risk of cardiovascular diseases including heart failure , according to the American Heart Association .

“ We know estrogens ingested orally are metabolized through the liver , and this is associated with an increase in factors that can lead to higher blood pressure ,” lead study author Dr Cindy Kalenga , a Ph . D . candidate at the University of Calgary in Alberta , Canada , said in a press release .

The study comprised over 112,000 women who underwent at least two consecutive six-month cycles of oestrogen therapy . Researchers analysed the relationship between different oestrogen therapies ( oral , topical , and vaginal administrations ) and the risk of developing high blood pressure one year after starting treatment .

The results show that women undergoing oral oestrogen therapy had a 14 percent higher risk of developing blood pressure compared to those using topical forms and a 19 percent higher risk than women taking vaginal oestrogen creams or suppositories . Taking a higher dose of oestrogen or taking it for longer was associated with a higher risk .

Dr Kalenga said that there were oestrogen therapies exposing women to lower risk . “ These may include low-dose , non-oral estrogen — like estradiol , in transdermal or vaginal forms — for the shortest possible time period , based on individual symptoms and the risk�benefit ratio , she said . “ These may also be associated with the lowest risk of hypertension . Of course , this must be balanced with the important benefits of hormone therapy , which include treatment of common menopausal symptoms .”

Gut bacteria might protect against heart disease

Early results suggest certain bacteria may reduce plaque formation in arteries

acteria that can be found in the gut of both humans and mice might help keep at bay the formation of plaques in arteries , a major cause of cardiovascular disease as they could obstruct blood flow .

Researchers from the University of Wisconsin- Madison identified the bacteria able to eliminate uric acid , a substance that could cause the painful joint condition called gout while also promoting plaque formation . First , they analysed the relationship between uric acid levels and gut bacteria in nearly 1,000 people . “ Uric acid levels also correlate with the patterns of different bacteria present in the gut of these people ,” Federico Rey , UW-Madison professor of bacteriology and an author of the new study , said in a press release . Secondly , they transplanted gut microbes from mature mice to those born with microbe-free guts and observed that mice receiving microbes from animals with lots of plaques and high uric acid levels developed the same condition . Similarly , mice who received microbes from animals with fewer plaques and lower uric acid were healthier . “ That led us to a cluster of genes , found across many different types of bacteria , necessary to break down purines and uric acid in the intestine ,” Rey said in the press release . “ When these purine-degrading microbes were using uric acid in the gut for their own needs there was less uric acid present in the blood of mice .”

The next step of the research is to investigate whether giving animals with arterial plaques purineeating bacteria will improve their cardiovascular disease .

“ It ’ s very premature to say introducing them in people could help them with cardiovascular disease or even gout . But we have a new understanding of one way the gut microbiome modulates the abundance of this inflammatory compound , and that may point the way to new treatments ,” he said .

18 ISSUE 3 | 2023 GlobalHealthAsiaPacific . com