更年期荷尔蒙疗法和中风风险:全国性队列研究
Sung Pil Choo1, Hyunji Park2, Hyemin Park3
1Department of Obstetrics & Gynecology, Inha University College of Medicine, Incheon, Korea.
Yonsei medical journal
|June 24, 2025
概括
当前更年期激素治疗 (MHT) 的使用增加了缺血性中风风险,特别是仅用雌激素或tibolone. 在停止MHT后风险恢复正常,显示过去的使用与更高的中风风险无关.
科学领域:
- 心血管健康 心血管健康
- 内分泌学 在内分泌学.
- 神经学 神经学
背景情况:
- 更年期激素治疗 (MHT) 的使用是常见的管理更年期症状.
- 虽然在早期启动时对冠心病风险有益,但MHT对中风风险的影响仍在争论中.
- 相互矛盾的证据需要进一步调查MHT与缺血性中风的关联.
研究的目的:
- 调查更年期激素治疗 (MHT) 使用与缺血性中风风险之间的关联.
- 根据MHT类型分析中风风险:当前用户,过去用户和从未使用过用户.
- 评估特定的MHT配方 (例如,仅含雌激素,提博隆) 对缺血性中风风险的影响.
主要方法:
- 使用韩国国家医疗保险服务数据 (2004-2015) 进行的回顾性队列研究.
- 包括45-60岁的女性,以前没有心血管疾病或中风.
- 参与者的分类为从未,过去和当前的MHT用户.
主要成果:
- 目前的MHT使用者表现出明显更高的缺血事件风险 (HR:2.98).
- 仅使用雌激素的MHT (HR: 3.49) 和tibolone (HR: 3.52) 与特别高的缺血事件风险有关.
- 过去的MHT使用与从未使用者相比,缺血事件风险没有显著差异.
结论:
- 目前使用MHT,特别是仅用雌激素或提博,与没有先前存在心血管疾病的女性的缺血性中风风险增加有关.
- 与MHT相关的高风险在停止治疗后减少,恢复到基线水平.
- 过去使用MHT似乎不会增加缺血性中风的风险.
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