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Long-term study finds modern hormone replacement therapy not linked to heart disease risk

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Long-term study finds modern hormone replacement therapy not linked to heart disease risk

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Contemporary hormone replacement therapy (HRT) was not associated with an increased risk of heart attack, stroke, blood clots or death among women ages 45 to 59, according to a large, long-term study of more than 52,000 women in Israel. The findings from this independent, preliminary research will be presented at the American Heart Association's Scientific Sessions 2026. The meeting is Nov. 6–9 in Chicago.

"Concerns that hormone replacement therapy may affect the heart are one of the most common reasons women decline hormone therapy to manage menopause symptoms, and why some health care professionals may hesitate to offer it," said lead study researcher Ronen Arbel, Ph.D., a researcher in the community medical services division of Clalit Health Services in Tel Aviv, Israel, and a researcher with Sapir College's Maximizing Health Outcomes Research Lab in Sderot, Israel.

Previous randomized trials found associations between HRT and cardiovascular harm. However, results were mixed, and much of that evidence came from studies involving older HRT formulations that are no longer commonly used, higher doses and women who started HRT long after menopause. Current clinical guidelines from the American College of Obstetricians and Gynecologists recommend starting HRT within 10 years of menopause onset and before age 60.

In November 2025, the FDA removed the "black box" warnings from HRT products after a comprehensive review of current scientific data indicating that HRT is not associated with an increased risk of cardiovascular disease, breast cancer or dementia.


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