Menopausal hormone therapy and coronary heart disease: the roller-coaster history.

IF 2.9 4区 医学 Q1 OBSTETRICS & GYNECOLOGY
Climacteric Pub Date : 2024-02-01 Epub Date: 2024-01-15 DOI:10.1080/13697137.2023.2282690
M Nudy, J Buerger, S Dreibelbis, X Jiang, H N Hodis, P F Schnatz
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引用次数: 0

Abstract

In the USA it is estimated that more than one million women become menopausal each year. Coronary heart disease (CHD) is the leading cause of mortality in menopausal woman globally. The majority of perimenopausal to postmenopausal women experience bothersome symptoms including hot flashes, night sweats, mood liability, sleep disturbances, irregular bleeding and sexual dysfunction. While menopausal hormone therapy (HT) effectively treats most of these symptoms, use of HT has become confusing, especially related to CHD risk. Despite years of observational and retrospective studies supporting a CHD benefit and improved survival among HT users, the Heart and Estrogen/Progestin Replacement Study (HERS) and the Women's Health Initiative (WHI) raised doubts about this long-held premise. The timing hypothesis has since emerged and states that when HT is initiated in younger women, soon after menopause onset, there may be cardiovascular benefit. The following review discusses the roller-coaster history of HT use as it pertains to CHD in postmenopausal women. Studies that highlight HT's CHD benefit are reviewed and provide reassurance that HT utilized in appropriately selected younger postmenopausal women close to the onset of menopause is safe from a cardiovascular perspective, in line with consensus recommendations.

更年期激素疗法与冠心病:过山车般的历史。
据估计,美国每年有 100 多万妇女绝经。冠心病(CHD)是全球更年期妇女死亡的主要原因。从围绝经期到绝经后,大多数妇女都会出现令人烦恼的症状,包括潮热、盗汗、情绪不稳、睡眠障碍、不规则出血和性功能障碍。虽然绝经期激素疗法(HT)能有效治疗大部分这些症状,但 HT 的使用已变得令人困惑,尤其是与心脏病风险有关的症状。尽管多年来的观察性和回顾性研究都支持更年期荷尔蒙疗法对冠心病有好处,并能提高更年期荷尔蒙疗法使用者的生存率,但 "心脏与雌激素/孕激素替代研究"(HERS)和 "妇女健康倡议"(WHI)对这一长期坚持的前提提出了质疑。此后,出现了时机假说,即年轻女性在绝经后不久开始使用 HT,可能会对心血管有益。下面的综述将讨论使用 HT 与绝经后女性冠心病相关的过山车式历史。回顾了强调 HT 对心血管疾病有益的研究,并再次保证,从心血管角度来看,在接近绝经期的年轻绝经后女性中适当选择使用 HT 是安全的,这与共识建议是一致的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Climacteric
Climacteric 医学-妇产科学
CiteScore
1.70
自引率
7.10%
发文量
53
审稿时长
1 months
期刊介绍: Climacteric is the official journal of the International Menopause Society (IMS). As an international peer-reviewed journal it publishes original research and reviews of all aspects of aging in women. Climacteric was founded by the IMS in 1998 and today has become a leading journal in the publication of peer-reviewed papers on the menopause, climacteric and mid-life health. Topics covered include endocrine changes, symptoms attributed to the menopause and their treatment, hormone replacement and alternative therapies, lifestyles, and the counselling and education of peri- and postmenopausal women. Climacteric, published bimonthly, also features regular invited reviews, editorials and commentaries on recent developments. The editorial review board of Climacteric includes leading scientific and clinical experts in the field of midlife medicine and research and is headed by its Editor-in-Chief, Professor Rod Baber of Australia. He and his team of Associate Editors act independently to set a clear editorial policy, co-ordinate peer review, and ensure a rapid response to submitted papers.
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