閉経後のホルモン療法と心血管疾患のリスク,年齢と閉経後数年の別
Jacques E Rossouw1, Ross L Prentice, JoAnn E Manson
1Women's Health Initiative Branch, National Heart, Lung, and Blood Institute, Bethesda, Md 20892, USA. rossouwj@nih.gov
JAMA
|April 5, 2007
まとめ
更年期に近い時期にホルモン療法を開始すると,冠動脈疾患 (CHD) のリスクが低下する傾向を示しました. しかし,ホルモン療法は閉経のタイミングに関係なく脳卒中のリスクを増加させ,長期使用には注意を促した.
科学分野:
- 心血管の健康についてです.
- 閉経研究 閉経研究
- ホルモン療法研究 ホルモン療法研究
背景:
- ホルモン療法の開始タイミングは,心血管疾患 (CVD) の効果に影響を与える可能性があります.
- これらの効果を理解することは,閉経後の女性にとって極めて重要です.
研究 の 目的:
- 心血管疾患のリスクに対するホルモン療法の影響が年齢や更年期以降の時間によって異なるかどうかを調査する.
- ホルモン療法の開始タイミングと心血管疾患との関係を分析する.
主な方法:
- 女性の健康イニシアティブ (WHI) のランダム化対照試験の二次分析.
- 閉経後の女性がランダムに併用された馬性エストロゲン (CEE) またはCEEプラスメドロキシプロゲステロンアセテート (MPA) とプラセボに割り当てられた.
- 統計的トレンドテストは,年齢および更年期以降の年齢カテゴリーにおける影響を評価するために使用されました.
主要な成果:
- ホルモン療法は脳卒中のリスクを増加させた (HR, 1.32).
- 冠動脈疾患 (CHD) リスクの減少傾向は,更年期に近い時期に治療を開始した女性で観察されました (P for trend = .02).
- この傾向は統計的に有意ではなく,閉経のタイミングに関係なく,脳卒中リスクは上昇していた.
結論:
- 閉経期に近い時期にホルモン療法を開始した女性は,閉経期より遠い女性と比較して,心臓病のリスクが低下する傾向を示しました.
- 閉経から何年経っても,脳卒中のリスクは高かった.
- これらの発見は,ホルモン療法による短期的な更年期症状管理を慎重に検討することを示唆しています.
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