Discover how hormone optimization supports heart health. Learn the latest research on hormone replacement therapies for cardiovascular protection.
Cardiovascular disease is among the leading causes of death worldwide, accounting for 32% of deaths globally. When improving heart health, we would usually think of lifestyle habits like diet and exercise. However, hormones are another factor that is often underestimated and overlooked.
Hormonal shifts can affect cardiovascular function by influencing blood pressure and vascular health. Hormonal imbalances occur as we age, and these imbalances cause symptoms that may possibly be associated with certain cardiovascular diseases.
Through hormone optimization, we can maintain a healthy cardiovascular system and reduce the risk of long-term health issues.
Hormone optimization either replaces or reinforces the production of hormones in the body to offset unwanted symptoms of hormonal imbalance, such as:
Hormone optimization minimizes the effects of declining hormone production with age and reduces the adverse effects associated with certain diseases.
The following section discusses and explores recent studies on hormone replacement therapies (HRTs) that aid in hormone optimization and protection of heart health.
Emerging evidence highlights the potential of estrogen therapy to improve key cardiovascular biomarkers in postmenopausal women.
A 2025 analysis of the Women’s Health Initiative clinical trials found that oral conjugated equine estrogens (CEE), alone or combined with medroxyprogesterone acetate (MPA), resulted in these effects over six years:
These changes suggest estrogen therapy may offer protective cardiovascular effects when carefully managed in the appropriate patient population.
Another study discussed the recommended routes of estrogen HRT depending on the age and cardiovascular risk category of women.
According to the findings, oral estrogen-based HRT was linked to an increased risk of stroke and venous thromboembolism, particularly in older women and those with pre-existing cardiovascular diseases.
On the other hand, transdermal estrogen had a lower risk for thromboembolism, making it a recommended option for women with moderate risk for cardiovascular diseases.
The table below shows the summary of recommended routes per cardiovascular risk categories:
Testosterone replacement therapy (TRT) may support cardiovascular health in men with low testosterone levels.
TRT has been shown to provide measurable cardiovascular benefits, including:
A 2023 randomized controlled trial followed 5,246 men from 45 to 80 years old with low testosterone levels (below 300 ng/dL), more than half of whom had existing cardiovascular disease.
Over 22 months, men who received TRT gel to maintain hormone levels between 350–750 ng/dL showed no increased risk of heart attacks, strokes, or cardiovascular death compared to those given a placebo.
However, TRT users were more likely to develop atrial fibrillation and pulmonary embolism, emphasizing the need for individualized risk assessment.
A 2021 systematic review and meta-analysis of randomized controlled trials discussed the benefits of thyroid hormone replacement therapy, particularly for individuals with heart failure and low triiodothyronine (low-T3) syndrome.
Aside from raising free triiodothyronine concentrations, findings revealed significant improvements across various cardiac parameters, including:
Another study conducted in 2024 found that standard treatment with levothyroxine (LT4) not only restores thyroid hormone levels but also aids in:
The same study discovered a new compound named LH4, which effectively relieved hypothyroidism symptoms. This compound may also potentially be an alternative for those who do not respond well to common thyroid hormone treatments.
Emerging research suggests that hormone replacement therapies improve cardiovascular biomarkers and reduce the risk of long-term disease.
For both doctors and patients, staying up to date on hormone therapies offers new possibilities for preventing disease and maintaining heart health.
