Study Finds Modern Hormone Therapy Does Not Raise Heart Disease Risk

What the Long-Term Israeli Study Evaluated

Contemporary hormone replacement therapy (HRT) does not raise the risk of heart attack, stroke, blood clots, or early death in women ages 45 to 59.

Researchers at Clalit Health Services and Sapir College analyzed records for more than 52,000 women in Israel who had no prior diagnosis of cardiovascular disease. The independent study tracked health outcomes over an average follow-up period of 12 years to compare women who started modern HRT against those who did not.

The preliminary research will be presented at the American Heart Association (AHA) Scientific Sessions 2026 in Chicago. Fear of cardiovascular complications remains one of the primary reasons patients and clinicians avoid hormone therapy for menopause symptoms.

Cardiovascular and Mortality Outcomes in Numbers

Cardiovascular event rates and overall mortality remained nearly identical between the two study cohorts throughout the 12-year observation window.

Heart attacks, strokes, or related cardiovascular events occurred in 2,311 women (4.4%) in the HRT cohort compared to 2,383 women (4.6%) in the untreated group. Death before age 80 occurred in 659 women (1.3%) who took hormone therapy versus 653 women (1.2%) who did not take it.

Venous thromboembolism rates were also equivalent between both arms of the study.

• Heart disease events occurred in 4.4% of HRT users versus 4.6% of non-users.
• Premature death before age 80 occurred in 1.3% of HRT users versus 1.2% of non-users.
• Blood clots occurred in exactly 0.33% of both groups (174 women on HRT versus 175 non-users).
• Outcomes remained consistent across oral, patch, and gel administration routes.

Why Modern Formulations Differ from Older Trials

Earlier clinical trials linked hormone replacement therapy to cardiovascular harm because those studies tested older formulations and higher doses in older postmenopausal populations.

The American College of Obstetricians and Gynecologists (ACOG) recommends initiating HRT within 10 years of menopause onset and before age 60. Timing and dosage determine cardiovascular safety.

In November 2025, the Food and Drug Administration (FDA) removed boxed warnings from HRT products after an extensive evidence review. That federal review concluded contemporary hormone therapy does not increase the risk of cardiovascular disease, breast cancer, or dementia.

Study Limitations and Clinical Considerations

These observational findings apply specifically to women ages 45 to 59 who start hormone therapy near menopause without preexisting heart disease.

The study is observational and preliminary, which means it shows an association rather than direct randomized proof. Women with established cardiovascular conditions or history of clotting disorders were excluded from this analysis.

Individuals experiencing menopause symptoms should review their personal cardiovascular risk factors with a qualified clinician before selecting a hormone therapy route.