非激素治疗更年期的血管运动症状
Anjali Goyal1, Adrianus Ekelmans1, John Cerjak1
1From the Department of Medicine, New York Medical College School of Medicine, Valhalla, NY.
Cardiology in review
|March 6, 2025
概括
非激素疗法有效地管理更年期的血管运动症状 (VMS),如热. 这些替代方案提供了心血管安全性,特别是对于心脏病风险增加的妇女来说.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 心血管健康 心血管健康
- 药理学 药理学是指药理学的学科.
背景情况:
- 血管运动症状 (VMS),包括热和夜间出汗,影响超过80%的绝经妇女,显著影响生活质量.
- 激素替代疗法 (HRT) 是有效的,但携带风险,如乳腺癌和心血管疾病 (CVD),推动对替代品的需求.
- 绝经后妇女因雌激素缺乏而面临心血管疾病风险增加,需要VMS治疗,这也支持心血管健康.
研究的目的:
- 审查绝经期血管运动症状 (VMS) 的非激素治疗方法的疗效和心血管安全性.
- 在绝经后的妇女中确定缓解症状而不会加剧心血管风险的VMS疗法.
主要方法:
- 对临床试验和关于非激素VMS治疗的现有文献的审查.
- 对药理学药物的检查 (SSRI,SNRIs, gabapentin,clonidine,NK-3受体对抗剂),生活方式的修改,针和认知行为疗法.
- 与VMS疗效数据一起评估心血管安全概况.
主要成果:
- SSRI (例如,帕洛克) 和SNRI (例如,芬拉法辛) 显示出显著的VMS缓解,为避免HRT的女性提供了替代方案.
- 神经基因-3受体对抗剂 (例如,fezolinetant) 在减少热方面表现有前途,没有观察到心血管不良影响.
- 各种非激素选择提供了可行的症状管理,其中一些显示潜在的心血管益处或中立性.
结论:
- 非荷尔蒙疗法是有效和更安全的替代方案,用于管理VMS,特别是对于妇女有对HRT的禁忌或心血管疾病风险增加.
- 新兴的治疗方法,如神经素-3受体抗剂,为VMS管理提供了新的途径,具有良好的心血管安全概况.
- 需要进一步的研究来证实长期的疗效和安全性,但目前的证据支持改善更年期生活质量的非激素选择.
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