Περίληψη:
Transition to menopause is associated with an increase in cardiovascular disease (CVD) risk, mainly attributed to lipid and glucose metabolism dysregulation, as well as to body fat redistribution, leading to abdominal obesity. Indeed, epidemiological evidence suggests that both early menopause (EM, defined as age at menopause <45 years) and premature ovarian insufficiency (POI, defined as age at menopause <40 years) are associated with 1.5-2-fold increase in CVD risk. Menopausal hormone therapy (MHT) exerts a favorable effect on CVD risk factors (with subtle differences regarding oestrogen dose, route of administration, monotherapy or combination with progestogen and type of progesto-gen). Concerning CVD morbidity and mortality, most studies have shown a beneficial effect of MHT in women at early menopausal age (<10 years since the final menstrual period) or younger than 60 years. MHT is strongly recommended in women with EM and POI, as these women, if left untreated, are at risk of CVD, osteoporosis, dementia, depression and premature death. MHT has also a favorable bene-fit/risk profile in perimenopausal and early postmenopausal women, provided that the patient is not at a high CVD risk (as assessed by 10-year calculation tools). Transdermal oestrogens have a lower risk of thrombosis compared with oral regimens. Concerning progestogens, natural progesterone and dydrogesterone have a neutral effect on CVD risk factors. In any case, the decision for MHT should be individualized, tailored according to the symptoms, patient preference and the risk of CVD, thrombotic episodes and breast cancer. © 2019 Bentham Science Publishers.
Συγγραφείς:
Anagnostis, P.
Paschou, S.A.
Katsiki, N.
Krikidis, D.
Lambrinoudaki, I.
Goulis, D.G.
Λέξεις-κλειδιά:
blood clotting factor; glucose, abdominal obesity; blood clotting disorder; blood pressure; body weight; cardiovascular disease; cardiovascular risk; diabetes mellitus; dyslipidemia; evidence based practice; female; glucose metabolism; hormonal therapy; human; lipid fingerprinting; menopause; metabolic syndrome X; postmenopause; Review; adult; adverse event; age; cardiovascular disease; drug effect; early menopause; estrogen therapy; menopause; metabolism; middle aged; pathophysiology; protection; risk factor; treatment outcome, Adult; Age Factors; Cardiovascular Diseases; Estrogen Replacement Therapy; Female; Humans; Menopause; Menopause, Premature; Middle Aged; Protective Factors; Risk Factors; Treatment Outcome
