激素替代疗法和急性心肌梗塞的发生率. 一个基于人口的嵌套病例控制研究
C Varas-Lorenzo1, L A García-Rodríguez, S Perez-Gutthann
1Global Epidemiology, Development, Novartis Farmacéutica, S.A. Barcelona, Spain. cristina.varas@pharma.novartis.com
Circulation
|June 7, 2000
概括
在健康妇女中使用激素替代疗法 (HRT) 与冠状动脉心脏病 (CHD) 的风险降低有关. 口服和透皮HRT都可能提供类似的心脏保护益处,其效果持续超过初次使用.
科学领域:
- 心血管健康 心血管健康
- 内分泌学 在内分泌学.
- 流行病学 流行病学
背景情况:
- 流行病学研究表明,激素替代疗法 (HRT) 可能会降低健康女性冠心病 (CHD) 风险.
- 关于口服和透皮HRT制剂是否具有这种心脏保护作用,存在不确定性.
研究的目的:
- 调查HRT使用 (口服和透皮) 与50-74岁女性急性心肌梗塞 (AMI) 风险之间的关联.
- 为了比较不同HRT配方和使用时间的心脏保护作用.
主要方法:
- 基于人口的病例控制研究嵌入英国队列 (1991-1995).
- 利用通用实践研究数据库,确定了1013个确诊的AMI病例和5000个匹配的对照.
- 经风险因素和并发症调整.
主要成果:
- 当前/最近使用HRT与AMI的几率比率 (OR) 降低 (0.72;95% CI 0.59至0.89).
- 在使用1年后观察到心脏保护作用,第一年没有增加风险.
- 口服和透皮治疗都显示出保护作用 (OR分别为0.63和0.62),特别是在中高剂量的雌激素中.
结论:
- 这些发现支持先前关于口服HRT在没有心脏病的女性中的心脏保护作用的报告.
- 建议通过皮肤进行的HRT可能会提供类似的心脏保护益处,尽管基于较少的用户.
- 在HRT停止后2-3年,保护作用会减弱.
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