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过早自然和手术更年期与心血管疾病的关联

Michael C Honigberg^1,2,3,4, Seyedeh Maryam Zekavat^3,4,5, Krishna Aragam^1,2,3,4

¹Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston.

|November 19, 2019

概括

在40岁之前经历过过早更年期的女性, 无论是自然的还是手术的, 晚年心血管疾病的风险略有增加. 这一发现强调了在对心脏健康的风险评估中考虑早期更年期的重要性.

科学领域:

心血管医学
生殖内分泌学
流行病学

背景情况:

最近的指导方针建议使用40岁前更年期史来改善中年女性的心血管疾病 (CVD) 风险评估.
然而,关于过早更年期的女性心血管疾病风险的可靠数据有限.
了解早期更年期对心血管的长期影响对于预防性保健至关重要.

研究的目的:

在40岁之前经历自然或手术更年期的妇女中调查心血管疾病和相关风险因素的发展.
为了比较过早更年期的妇女和没有更年期的妇女之间的心血管结果.

主要方法:

一项使用英国生物库数据的队列研究,其中包括144,260名40-69岁的绝经后妇女.
参与者被分为三个组:自然过早更年期,手术过早更年期 (都在40岁之前),没有过早更年期 (参考组).
随访时间平均为7年,评估主要心血管疾病和二次结果,如高血压和2型糖尿病.

主要成果:

与基准组相比,自然过早更年期 (3. 4%) 和手术过早更年期 (0. 4%) 的女性患初级复合心血管结局的发病率显著更高.
每 1000 个女性年发生率为自然更年期的8. 78%,手术更年期的11. 27%,而没有更年期的患者为5. 70%.
经过调整后的分析显示,自然 (HR,1. 36) 和手术 (HR,1. 87) 的过早更年期都与心血管疾病风险增加有关,即使考虑到常规风险因素和激素治疗使用.

结论:

在40岁前的自然和手术过早更年期与经更年期妇女的复合心血管疾病风险的统计显著增加有关,尽管很小.
这些发现强调需要将早期更年期史纳入心血管疾病风险分层策略.
需要进一步研究以阐明推动这些关联的潜在生物机制.

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