阴道雌激素的使用是否会增加心血管不良结果的风险?
Jacqueline Hendrix1, Ethan Chang1, Vivian Cheng1
1Valley Family Medicine, Renton, WA.
The Journal of family practice
|November 17, 2023
概括
非口服雌激素,特别是阴道雌激素,与治疗更年期症状的口服雌激素相比,与较低的心血管风险概况有关. 阴道雌激素的使用显示出降低了冠状动脉心脏病的风险,以及其他心血管事件的类似风险与不使用相比.
科学领域:
- 心血管健康 心血管健康
- 更年期的荷尔蒙疗法 更年期的荷尔蒙治疗
- 药理学 药理学是指药理学的学科.
背景情况:
- 对更年期症状的口服雌激素治疗引起了有关心血管风险的担忧.
- 作为潜在的更安全的替代品,正在研究非口服雌激素施用途径.
- 了解与不同雌激素配方相关的心血管 (CV) 风险概况对于临床实践至关重要.
研究的目的:
- 为了比较与非口服与口服雌激素使用相关的心血管风险,用于更年期症状.
- 为了评估阴道雌激素治疗的特定心血管风险与非使用相比.
主要方法:
- 对评估雌激素使用和心血管结果的队列研究进行系统审查和元分析.
- 对比非口服雌激素,口服雌激素和非使用的数据的分析.
- 针对阴道雌激素使用和特定心血管事件 (心脏病,心脏病发作,中风,心脏病发作/心脏病发作) 和死亡率的分层分析.
主要成果:
- 非口服雌激素的使用通常比口服雌激素的使用具有较低的心血管风险.
- 与不使用相比,阴道雌激素使用与冠状动脉心脏病 (CHD) 的风险降低有关.
- 与不使用相比,阴道雌激素治疗对心肌梗塞 (MI),中风和深静脉血栓/肺栓塞 (DVT/PE) 具有相似的风险.
- 3至5年的随访表明,使用阴道雌激素疗法与不使用相比,与心血管相关的死亡率较低.
结论:
- 非口服雌激素,特别是阴道途径,似乎与治疗更年期症状的口服雌激素相比,具有更有利的心血管风险概况.
- 阴道雌激素治疗可能提供心血管方面的好处,包括降低心血管疾病风险和死亡率,而不会显著增加其他主要心血管不良事件的风险.
- 需要进一步进行高质量的随机试验,以确定非口服雌激素配方的心血管安全性和疗效.
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