**Core Concept**
Hormone therapy in menopausal women is primarily used to alleviate symptoms of estrogen deficiency, such as hot flashes and vaginal dryness, and to prevent osteoporosis. This therapy involves the administration of estrogen and/or progesterone to maintain hormonal balance and alleviate menopausal symptoms.

**Why the Correct Answer is Right**
The primary indication for hormone therapy in menopausal women is to reduce the risk of osteoporosis and alleviate symptoms of estrogen deficiency. This is achieved through the administration of estrogen, which stimulates osteoblast activity and maintains bone density. Additionally, estrogen replacement therapy can also help alleviate hot flashes, night sweats, and vaginal dryness associated with menopause. The most commonly used hormone therapy regimens include estrogen alone for women who have undergone hysterectomy and estrogen combined with progesterone for women with an intact uterus.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because hormone therapy is not primarily indicated for the management of anxiety or depression in menopausal women, although these symptoms may be alleviated as a secondary effect of hormone therapy.

**Option B:** This option is incorrect because hormone therapy is not indicated for the treatment of hypertension in menopausal women, although blood pressure may be affected by hormone therapy.

**Option C:** This option is incorrect because hormone therapy is not primarily indicated for the prevention of cardiovascular disease in menopausal women, although estrogen therapy may have some protective effects on cardiovascular health.

**Clinical Pearl / High-Yield Fact**
A key consideration when initiating hormone therapy in menopausal women is the risk of thromboembolic events, which is increased with estrogen therapy. Therefore, hormone therapy should be used judiciously and for the shortest duration necessary to alleviate menopausal symptoms.

**Correct Answer:** D.