The effectiveness of the treatment of menopause (coronary heart disease)

The effectiveness of the treatment of menopause (coronary heart disease)

Class 3 interventions are associated with a risk factor (RF), which is still being studied today. For some risk factors (RF), causal dependence with coronary heart disease (CHD) cannot be determined due to limited data. For some DFs with obvious causal dependence, interventions are not yet available. Clinicians should be prepared to discuss these risk factors with their patients, since they are an area of ​​active research and are often in the focus of media attention.

The risk associated with menopause (menopause). Up to 45 years, a relatively small number of women in the United States and other developed countries suffer from cardiovascular diseases (CVD). However, by age 60, CVDs have become the leading cause of death among women. Although the incidence of CHD in men of any age is higher, as is mortality from CHD, this gap is significantly reduced after natural menopause or bilateral removal of the ovaries in women.

The increased risk of coronary heart disease (CBS) after menopause can be explained by adverse changes in lipid and carbohydrate metabolism, which leads to an increase in LDL cholesterol and reduced HDL cholesterol, an increase in glucose tolerance (IGT) changes in hemostatic factors and vascular function. These changes have long been associated with a decrease in endogenous estrogen, which usually accompanies menopause.

Many observational studies have suggested that the use of hormonal drugs after menopause reduces the risk of KBS. A meta-analysis of 40 cohort and case-control studies showed a 50% reduction in the risk of KBS after using estrogens. In an early analysis of the Nurses’ Health Study, one of the largest cohort studies that studied this issue, the risk of KBS was 50% lower in women who took estrogens (relative risk 0.51; 95% CI 0.37-0.70).

These data, together with the known beneficial effects of estrogen per os on the lipid profile, became the basis for the widespread use of hormone therapy after menopause for the prevention of CVD.

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