Cardiovascular risk in menopausal women and prevalent related co-morbid conditions: facing the post-Women's Health Initiative era

被引:108
作者
Perez-Lopez, Faustino R. [1 ]
Chedraui, Peter [2 ]
Gilbert, Juan J. [2 ]
Perez-Roncero, Gonzalo [3 ]
机构
[1] Univ Zaragoza, Hosp Clin Univ Zaragoza, Dept Obstet & Gynaecol, Fac Med, E-50009 Zaragoza, Spain
[2] Univ Catolica Santiago Guayaquil, Inst Biomed, Guayaquil, Ecuador
[3] Inst Ginecol Zaragoza, Zaragoza, Spain
关键词
Menopause; cardiovascular disease; hormone therapy; depression; sleeping disorders; vitamin D insufficiency; psychosocial factors; obesity; HORMONE-REPLACEMENT THERAPY; CORONARY-HEART-DISEASE; OBESE POSTMENOPAUSAL WOMEN; VASCULAR ENDOTHELIAL-CELLS; VITAMIN-D SUPPLEMENTATION; ENDOGENOUS SEX-HORMONES; SHORT-SLEEP DURATION; TREATMENT PANEL-III; MIDDLE-AGED WOMEN; QUALITY-OF-LIFE;
D O I
10.1016/j.fertnstert.2009.06.032
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To review scientific publications regarding cardiovascular risk during the menopausal years and that related to currently recognized highly prevalent co-morbid factors within this period. Methods: Citations were selected from a PubMed search and the authors' files according to their clinical and experimental relevance. Results and Discussion: Although experimental and some observational data have supported the fact that estrogens are beneficial for the female vascular system, these positive actions have been challenged by the results of the Women's Health Initiative trial and the Million Women Study, which demonstrated an increase in cardiovascular risk and related adverse events. The role of hormone therapy for the menopause has shifted from a preventive use to a limited role in symptom management, for which it remains the most effective intervention. Baseline evaluation of menopausal women should include individual cardiovascular risk assessment, including hypertension, dyslipidemia, elevated body weight, and the metabolic syndrome. Concomitantly, new factors influencing cardiovascular risk have been delineated among postmenopausal women, namely sleeping disorders, depression, vitamin D insufficiency, rheumatoid arthritis, sexual dysfunction, stress, and psychosocial factors. Therefore, a new landscape may be recognized for menopausal women management. Precise evaluation and treatment of each factor should be separately assessed to improve quality of life and reduce cardiovascular disease prevalence. At present, cardiovascular risk reduction strategies are a requisite (albeit underused) for menopausal women. These include education in terms of health, healthy lifestyle, and pharmacologic preventive interventions to reduce co-morbid conditions. (Fertil Steril (R) 2009;92:1171-86. (C) 2009 by American Society for Reproductive Medicine.)
引用
收藏
页码:1171 / 1186
页数:16
相关论文
共 47 条
[21]   Insulin Resistance and Risk of Cardiovascular Disease in Postmenopausal Women A Cohort Study From the Women's Health Initiative [J].
Schmiegelow, Michelle D. ;
Hedlin, Haley ;
Stefanick, Marcia L. ;
Mackey, Rachel H. ;
Allison, Matthew ;
Martin, Lisa W. ;
Robinson, Jennifer G. ;
Hlatky, Mark A. .
CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES, 2015, 8 (03) :309-+
[22]   Multivitamin Use and Risk of Cancer and Cardiovascular Disease in the Women's Health Initiative Cohorts [J].
Neuhouser, Marian L. ;
Wassertheil-Smoller, Sylvia ;
Thomson, Cynthia ;
Aragaki, Aaron ;
Anderson, Garnet L. ;
Manson, JoAnn E. ;
Patterson, Ruth E. ;
Rohan, Thomas E. ;
van Horn, Linda ;
Shikany, James M. ;
Thomas, Asha ;
LaCroix, Andrea ;
Prentice, Ross L. .
ARCHIVES OF INTERNAL MEDICINE, 2009, 169 (03) :294-304
[23]   Eating Disorders, Co-Morbid Disorders and Early Risk Factors Amongst Post-9/11 Veteran Men and Women [J].
Cooper, Zafra ;
Smith, Brian N. ;
Kehle-Forbes, Shannon ;
Dorset, Julianne ;
Mitchell, Karen S. .
JOURNAL OF CLINICAL PSYCHOLOGY, 2025, 81 (03) :133-144
[24]   'Tis but a scratch: a critical review of the Women's Health Initiative evidence associating menopausal hormone therapy with the risk of breast cancer [J].
Bluming, Avrum Z. ;
Hodis, Howard N. ;
Langer, Robert D. .
MENOPAUSE-THE JOURNAL OF THE MENOPAUSE SOCIETY, 2023, 30 (12) :1241-1245
[25]   Hormone replacement therapy and risk of cardiovascular disease - Implications of the results of the Women's Health Initiative [J].
Kuller, LH .
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 2003, 23 (01) :11-16
[26]   Cardiovascular Risk Factors in Community Women Vary Geographically--An Initiative of Sister to Sister: Women's Heart Health Foundation [J].
Jarvie, Jennifer L. ;
Johnson, Caitlin E. ;
Aslam, Farhan ;
Foody, JoAnne M. .
CIRCULATION, 2010, 122 (21)
[27]   History of Pregnancy Loss Predicts Coronary Heart Disease and Peripheral Vascular Disease in Post-Menopausal Women in the Women's Health Initiative (WHI) [J].
Parker, Donna R. ;
Lu, Bing ;
Sands, Megan ;
Eaton, Charles B. .
CIRCULATION, 2011, 124 (21)
[28]   Risk of cardiovascular disease by hysterectomy status, with and without oophorectomy - The Women's Health Initiative Observational Study [J].
Howard, BV ;
Kuller, L ;
Langer, R ;
Manson, JE ;
Allen, C ;
Assaf, A ;
Cochrane, BB ;
Larson, JC ;
Lasser, N ;
Rainford, M ;
Van Horn, L ;
Stefanick, ML ;
Trevisan, M .
CIRCULATION, 2005, 111 (12) :1462-1470
[29]   Association of glycemic load with cardiovascular disease risk factors: The Women's Health Initiative Observational Study [J].
Shikany, James M. ;
Tinker, Lesley F. ;
Neuhouser, Marian L. ;
Ma, Yunsheng ;
Patterson, Ruth E. ;
Phillips, Lawrence S. ;
Liu, Simin ;
Redden, David T. .
NUTRITION, 2010, 26 (06) :641-647
[30]   Pregnancy Loss is Associated With Higher Risk of Cardiovascular Disease Independent of Traditional and Nontraditional Cardiovascular Risk Factors: The Women's Health Initiative [J].
Hall, Philip S. ;
Nah, Gregory ;
Vittinghoff, Eric ;
Parker, Donna R. ;
Manson, JoAnn E. ;
Howard, Barbara V. ;
Sarto, Gloria E. ;
Gass, Margery L. ;
Sealy-Jefferson, Shawnita M. ;
Salmoirago-Blotcher, Elena ;
Stefanick, Marcia L. ;
Shadyab, Aladdin H. ;
Van Horn, Linda V. ;
Park, Ki ;
Parikh, Nisha I. .
CIRCULATION, 2017, 136