Effect of Hormone Replacement Therapy on Arterial Stiffness and Hemodynamics in Perimenopausal Women: A Pilot Prospective Study

Objective: To investigate the effects of hormone replacement therapy (HRT) on arterial stiffness and hemodynamic parameters in perimenopausal women. Methods: A total of 60 perimenopausal women who visited our menopausal clinic were enrolled in this prospective observational study. Among these, 28 women who received daily oral estradiol and dydrogesterone for 12 months composedthe HRT group, whereas 25 women who did not receive HRT composedthe control group. Pulse wave velocity (PWV) and wall shear stress (WSS) in the common carotid artery were assessed at baseline and after 12 months. Changes in the PWV and WSS were compared between the two groups. Results: There were no statistically significant differences in the changes in PWV orWSS between the HRT and control groups. However, the WSS increased significantly over the 12-month period in both groups (p < 0.05). Multiple linear regression analyses indicated that triglyceride and high-density lipoprotein (HDL) levels were independently associated with changes in PWV (p < 0.05). Conclusions: HRT did not significantly influence changes in arterial stiffness or hemodynamics over the study period. Nevertheless, the consistent increase in WSS across both groups may suggest early vascular aging during the menopausal transition. WSS may represent a novel and sensitive indicator of vascular aging in perimenopausal women.