Benefits for cardiovascular system, bone density, and quality of life of a long-term hormone therapy in hysterectomized women: a 20-year follow-up study Lorite Vílchez, María Isabel Cuadros Celorrio, Ángela María Rivera Izquierdo, Mario Sánchez Martín, Victoria Cuadros Celorrio, Marta Eugenia Cardiovascular Hormone therapy Hysterectomy Long-term effects Postmenopause This study was supervised by Full Professor José Luis Cuadros López, MD, PhD, who directed the menopause unit at Hospital Universitario San Cecilio for more than 30 years. We would like to express our gratitude to all women in his care who trusted him. Sit tibi terra levis. We would like to acknowledge Natalia Aptsiauri, PhD, for reviewing the manuscript. Objective The safety, consequences, and dosage of long-term hormone therapy (HT) for postmenopausal women remain unclear. Our aim was to analyze the effects of HT after 20 years of therapy in women after hysterectomy, focusing on the symptoms of menopause, blood pressure, lipid profiles, and bone density. Methods A prospective observational longitudinal study was designed. The initial transdermal estradiol dose was reduced in half (0.025 mg/d) at 60 years of age. Different parameters including demographic, cardiovascular, bone density, and metabolic variables, as well as quality of life characteristics, were analyzed using bivariate analyses. Multivariate generalized estimating equations for longitudinal data were fitted for differences over time and between doses (<60 vs ≥60 y) using the R package geepack. Results After 20 years of HT, the mean age of 56 studied hysterectomized women was 67.1 years. The mean Kupperman index score decreased from 26.7 to 12.0 (P < 0.001). A trend with total and low-density lipoprotein cholesterol reduction and high-density lipoprotein cholesterol increase was observed over time. A decrease in very-low-density lipoprotein cholesterol (P = 0.05) and an increase in T score vertebral densitometry (P = 0.014) were detected after HT. No changes in health outcome were detected in women older than 60 years with the reduced dose of HT. Breast cancer was the reason for dropouts in 0.02% women. Conclusions HT for up to 20 years after hysterectomy may be beneficial for bone and cardiovascular health and for the overall quality of life. Our data suggest the importance of evaluating the dose and the timing of HT. 2023-10-27T09:54:50Z 2023-10-27T09:54:50Z 2023-10 info:eu-repo/semantics/article Lorite, Maria Isabel MD, PhD1; Cuadros, Angela Maria MD, PhD1; Rivera-Izquierdo, Mario MD, PhD2,3; Sanchez-Martin, Victoria PhD4; Cuadros, Marta PhD3,5,6. Benefits for cardiovascular system, bone density, and quality of life of a long-term hormone therapy in hysterectomized women: a 20-year follow-up study. Menopause 30(10):p 995-1001, October 2023. [DOI: 10.1097/GME.0000000000002239] https://hdl.handle.net/10481/85303 10.1097/GME.0000000000002239 eng http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess Attribution-NonCommercial-NoDerivatives 4.0 Internacional Wolters Klower