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La terapia hormonal posmenopáusica se asocia con la progresión de la aterosclerosis en mujeres con tolerancia anormal
Barbara V Howard1, Judith Hsia, Pamela Ouyang
1MedStar Research Institute, 6495 New Hampshire Ave, Suite 201, Hyattsville, MD 20783, USA. Barbara.V.Howard@MedStar.net
Circulation
|July 1, 2004
Resumen
La terapia hormonal posmenopáusica empeora la aterosclerosis coronaria en mujeres con tolerancia anormal a la glucosa. La PHT no se recomienda para las mujeres diabéticas debido al aumento del riesgo cardiovascular y los marcadores inflamatorios.
Área de la Ciencia:
- Las enfermedades cardiovasculares son enfermedades cardiovasculares.
- Endocrinología Endocrinología.
- Salud de la mujer Salud de la mujer.
Sus antecedentes:
- La tolerancia anormal a la glucosa (AGT) aumenta el riesgo de enfermedad cardiovascular (ECV), especialmente en mujeres posmenopáusicas.
- La terapia hormonal posmenopáusica (PHT) se asocia con un mayor riesgo de ECV, con efectos similares observados en mujeres diabéticas y no diabéticas.
Objetivo del estudio:
- Investigar la hipótesis de que la PHT tiene un peor efecto sobre la enfermedad cardiovascular en mujeres posmenopáusicas con AGT.
Principales métodos:
- 423 mujeres posmenopáusicas con aterosclerosis, con o sin AGT, fueron asignadas al azar a PHT o placebo durante ~2.8 años.
- La progresión de la aterosclerosis coronaria se evaluó a través de angiogramas en serie.
- Se midieron los perfiles lipídicos, los marcadores inflamatorios (proteína C reactiva, fibrinógeno), la glucosa, la insulina y la resistencia a la insulina (HOMA).
Principales resultados:
- La PHT condujo a cambios más adversos en la proteína C reactiva y el fibrinógeno en mujeres con AGT.
- La progresión aterosclerótica fue mayor en las mujeres con AGT y fue mejorada por PHT.
- La PHT mostró ligeras mejoras en la glucosa en ayunas, la insulina y la resistencia a la insulina en mujeres con AGT.
Conclusiones:
- La PHT empeora la aterosclerosis coronaria y los marcadores inflamatorios en mujeres posmenopáusicas con AGT.
- La PHT no se recomienda para mujeres diabéticas debido a estos efectos adversos.
- Se necesita más investigación para explorar los beneficios potenciales de la PHT en la resistencia a la insulina y la glucemia en mujeres con AGT.
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