Physical activity and menopausal hormone therapy are associated with lower cardiovascular disease risk in post-menopausal females

Background The risk of cardiovascular disease (CVD) in females increases after menopause. Physical activity and menopausal status have been independently shown to influence CVD risk. However, the combination of moderate-to-vigorous physical activity (MVPA) with menopausal hormone therapy (MHT) on CVD risk has not been evaluated. Purpose To determine the influence of MVPA and MHT on CVD risk in post-menopausal females. Methods Medical history and physical data collected from 15,320 females (45-85y) via the Canadian Longitudinal Study on Aging (CLSA) were accessed and stratified by menopausal status (self-reported absence of menses for ≥12 months). Adjusted logistic regression models examining associations between self-reported MVPA (≥ 4 metabolic equivalents ≥150 min/wk), MHT (using vs. non-using) and CVD risk were performed in post-menopausal females with no known history of CVD. Models were adjusted for age, body mass index (BMI), smoking, education and income. CVD risk was defined as the presence ≥ 1 of the following: diabetes or high blood pressure (current or during pregnancy); taking diabetic, blood pressure, stroke or thyroid medications. Results A total of 7252 post-menopausal females were included [63 ± 8.5y]. MVPA was strongly and inversely related to CVD risk (β = –0.00373, OR = 0.996, p = 0.001) and HRT was modestly protective (β = –0.116, OR = 0.89, p = 0.038). Older age and higher body weight were consistently associated with increased risk (β = 0.048, OR = 1.05, p < 0.001 and β = 0.113, OR = 1.12, p < 0.001, respectively). Achieving ≥150 min/wk of MVPA was associated with a 14% lower CVD risk, and using MHT was associated with an additional 11% lower risk, independent of age and BMI. Conclusions Post-menopausal women engaging in MVPA displayed significantly reduced CVD risk, and MHT provided additional independent protection. Older age and higher body weight remained strong predictors of elevated CVD risk. These findings highlight the importance of physical activity while also supporting a potential complementary role for MHT in reducing CVD risk.For image description, please refer to the figure legend and surrounding text.