与更年期和更年期激素治疗相关的心血管风险:风险评估的审查和当代方法.
Zoee D'Costa1, Emily Spertus2, Shipra Hingorany3
1David Geffen School of Medicine, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA. zdcosta@mednet.ucla.edu.
Current atherosclerosis reports
|October 9, 2025
概括
更年期和激素治疗影响心血管风险. 建议采用个性化评估框架,以优化MHT启动期间的安全性和降低心脏病风险.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 妇女健康 妇女健康
背景情况:
- 更年期加快了由于荷尔蒙,代谢和血管变化的动脉样硬化心脏病风险.
- 更年期和MHT影响心血管风险因素和心脏病发作和中风等事件.
研究的目的:
- 讨论与更年期和MHT相关的心血管风险.
- 在开始MHT之前,提出个性化心血管风险评估的框架.
主要方法:
- 对MHT配方和心血管结果的临床试验证据的审查.
- 强调个性化评估,包括年龄,绝经以来的时间和基线心血管风险.
- 包括增加风险的因素和亚临床动脉样硬化成像用于全面的风险评估.
主要成果:
- 早期的MHT配方 (口服CEE与MPA) 显示心血管风险增加,特别是在老年女性中.
- 现代MHT (低剂量透皮雌激素,微化孕激素) 表明心血管风险较低.
- 个性化MHT启动需要考虑患者特定的因素和MHT特征.
结论:
- 更年期是实施心血管疾病预防策略的关键时期.
- 对MHT时间,配方和输送的结构化,个性化的方法可以提高心血管安全.
- 需要进一步的研究才能充分了解MHT的长期心血管影响.
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