雌激素和心血管疾病
Felice Gersh1, James H O'Keefe2, Andrew Elagizi3
1University of Arizona School of Medicine, Division of Integrative Medicine, Tucson, AZ, USA.
Progress in cardiovascular diseases
|January 25, 2024
概括
雌激素 (E2) 和孕激素 (P4) 提供心血管益处,它们的缺失与加速心血管疾病 (CVD) 有关. 使用E2和P4的激素替代疗法 (HRT) 可以预防绝经后妇女的心血管疾病,特别是当早期开始时.
科学领域:
- 生殖内分泌学和心血管科学.
- 研究性激素在心血管健康中的作用.
背景情况:
- 超过20年的广泛研究强调了雌激素 (E2) 和孕激素 (P4) 在生殖年龄妇女的心血管益处.
- 缺少卵巢E2和P4与加速心血管疾病 (CVD) 的发展有关.
- 使用E2和P4的激素替代疗法 (HRT) 已在更年轻的绝经妇女中证明是安全的.
研究的目的:
- 支持重新考虑E2和P4作为降低心血管疾病的预防疗法.
- 强调"定时假设"对于延迟绝经后妇女心血管疾病的重要性.
主要方法:
- 审查过去二十年累积的科学研究.
- 对与E2和P4.4相关的心血管益处和风险的数据分析.
- 在HRT启动的背景下考虑"时间假设".
主要成果:
- 强有力的科学数据支持E2和P4的心血管益处.
- 使用E2和P4的HRT在更年轻的绝经妇女中没有显示任何危害.
- 扩大对E2在心血管疾病发病中的调节作用的理解至关重要.
结论:
- 重新考虑处方E2和P4用于心血管疾病预防的使用是合理的,即使没有像WHI这样的大规模试验.
- 在卵巢功能停止后不久开始HRT ("时间假设") 应考虑延迟最近绝经后妇女的心血管疾病.
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