Abstract：
OBJECTIVE: Menopausal hormone therapy (HT) includes a wide variety of hormonal compounds, and its effect on blood pressure is still uncertain.
OBJECTIVE: The aim of this study was to assess evidence regarding the effect of HT on blood pressure in postmenopausal women and its association with arterial hypertension.
METHODS: This systematic review and meta-analysis included randomized clinical trials and prospective observational studies. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and the incidence of hypertension were assessed. All stages were independently performed by two reviewers. For blood pressure outcome, standardized mean differences (SMD) and 95% confidence intervals (95% CI) were calculated as effect measures. Heterogeneity was assessed using the I2 statistic. The results are presented based on the HT type. The incidence of hypertension was compared using descriptive analyses.
RESULTS: Eleven studies were included with 81,041 women evaluated, of which 29,812 used HT. The meta-analysis, conducted with 8 studies and 1,718 women, showed an increase in SBP with the use of oral conjugated equine estrogens plus progestogen (SMD = 0.60 mm Hg, 95% CI = 0.19 to 1.01). However, oral or transdermal use of estradiol plus progestogen (SMD = -2.00 mm Hg, 95% CI = -7.26 to 3.27), estradiol alone, and tibolone did not show any significant effect. No significant effect on DBP was observed for any formulation. Women who used oral estrogen plus progestogen had a higher risk of incident hypertension than those who never used it.
CONCLUSIONS: The effect of HT on blood pressure is influenced by the formulation used, especially the type of estrogen. The combined formulations of conjugated equine estrogens plus progestogen increased SBP and the risk of hypertension, which was not observed among estradiol plus progestogen, estradiol alone, and tibolone users.
OBJECTIVE: The aim of this study was to assess evidence regarding the effect of HT on blood pressure in postmenopausal women and its association with arterial hypertension.
METHODS: This systematic review and meta-analysis included randomized clinical trials and prospective observational studies. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and the incidence of hypertension were assessed. All stages were independently performed by two reviewers. For blood pressure outcome, standardized mean differences (SMD) and 95% confidence intervals (95% CI) were calculated as effect measures. Heterogeneity was assessed using the I2 statistic. The results are presented based on the HT type. The incidence of hypertension was compared using descriptive analyses.
RESULTS: Eleven studies were included with 81,041 women evaluated, of which 29,812 used HT. The meta-analysis, conducted with 8 studies and 1,718 women, showed an increase in SBP with the use of oral conjugated equine estrogens plus progestogen (SMD = 0.60 mm Hg, 95% CI = 0.19 to 1.01). However, oral or transdermal use of estradiol plus progestogen (SMD = -2.00 mm Hg, 95% CI = -7.26 to 3.27), estradiol alone, and tibolone did not show any significant effect. No significant effect on DBP was observed for any formulation. Women who used oral estrogen plus progestogen had a higher risk of incident hypertension than those who never used it.
CONCLUSIONS: The effect of HT on blood pressure is influenced by the formulation used, especially the type of estrogen. The combined formulations of conjugated equine estrogens plus progestogen increased SBP and the risk of hypertension, which was not observed among estradiol plus progestogen, estradiol alone, and tibolone users.
摘要：
目的：更年期激素治疗（HT）包括多种激素化合物，其对血压的影响仍不确定。
目的：本研究的目的是评估HT对绝经后妇女血压的影响及其与动脉高血压的关系的证据。
方法：本系统综述和荟萃分析包括随机临床试验和前瞻性观察性研究。收缩压（SBP），舒张压（DBP），并评估高血压的发病率。所有阶段均由两名审阅者独立进行。对于血压结果，计算标准化平均差(SMD)和95%置信区间(95%CI)作为效应指标.使用I2统计量评估异质性。结果基于HT类型给出。使用描述性分析比较高血压的发生率。
结果：纳入了11项研究，评估了81,041名女性，其中29,812使用HT。荟萃分析，进行了8项研究和1718名女性，显示使用口服结合马雌激素加孕激素的SBP增加（SMD=0.60mmHg，95%CI=0.19至1.01)。然而,口服或经皮使用雌二醇加孕激素（SMD=-2.00mmHg，95%CI=-7.26至3.27)，只有雌二醇,和替勃龙没有显示出任何显著的效果。对于任何制剂均未观察到对DBP的显著影响。使用口服雌激素加孕激素的女性比从未使用过的女性发生高血压的风险更高。
结论：HT对血压的影响受所用制剂的影响，尤其是雌激素的类型。结合马雌激素和孕激素的联合制剂增加了SBP和高血压的风险，在雌二醇加孕激素中没有观察到，只有雌二醇,和tibolone用户。
目的：本研究的目的是评估HT对绝经后妇女血压的影响及其与动脉高血压的关系的证据。
方法：本系统综述和荟萃分析包括随机临床试验和前瞻性观察性研究。收缩压（SBP），舒张压（DBP），并评估高血压的发病率。所有阶段均由两名审阅者独立进行。对于血压结果，计算标准化平均差(SMD)和95%置信区间(95%CI)作为效应指标.使用I2统计量评估异质性。结果基于HT类型给出。使用描述性分析比较高血压的发生率。
结果：纳入了11项研究，评估了81,041名女性，其中29,812使用HT。荟萃分析，进行了8项研究和1718名女性，显示使用口服结合马雌激素加孕激素的SBP增加（SMD=0.60mmHg，95%CI=0.19至1.01)。然而,口服或经皮使用雌二醇加孕激素（SMD=-2.00mmHg，95%CI=-7.26至3.27)，只有雌二醇,和替勃龙没有显示出任何显著的效果。对于任何制剂均未观察到对DBP的显著影响。使用口服雌激素加孕激素的女性比从未使用过的女性发生高血压的风险更高。
结论：HT对血压的影响受所用制剂的影响，尤其是雌激素的类型。结合马雌激素和孕激素的联合制剂增加了SBP和高血压的风险，在雌二醇加孕激素中没有观察到，只有雌二醇,和tibolone用户。
