Cardiovascular Risk/Benefit Profile of MHT

Villa, Paola; Amar, Inbal Dona; Shachor, Maayan; Cipolla, Clelia; Ingravalle, Fabio; Scambia, Giovanni

doi:10.3390/medicina55090571

Cited by 9 publications

(5 citation statements)

References 94 publications

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“…Even if women have some protection from CVD due to increased fat accumulation in the lower limbs, menopause leads to a decline in sex hormones (estrogen and progesterone), increasing fat in the trunk region and consequently increasing the CVD risk 36,37 . However, a favorable and low-risk profile on CVD in postmenopausal women using hormone replacement therapy was observed in previous studies 38,39,40,41,42,43,44,45,46 .…”

Section: Discussionmentioning

confidence: 88%

“…The following variables related to both exposure and outcome were considered as confounders for adjustment from the most relevant similar studies that investigated this association 30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48 : age as categories in descriptive analysis (≤ 44; 45 to 49; 50 to 54; 55 to 59; and 60 to 64 years old) and as continuous in multivariate analysis -to remove residual confounding -; educational attainment [university degree or more (> 15 years), high school (11-14 years), complete elementary school (8-10 years) and incomplete elementary school (0-7 years)]; self-reported skin color (white, brown-skinned or pardo, black, Asian descendant and Brazilian indigenous); leisure physical activity (light, moderate, and intense) assessed by the International Physical Activity Questionnaire (IPAQ) and; regarding alcohol consumption, the participants were categorized as: drinking moderately (men, consumption < 210g of alcohol and women, consumption < 140g of alcohol per week, nonuser, and drinking excessively (men, consumption ≥ 210g of alcohol and women, consumption ≥ 140g of alcohol per week).…”

Section: Covariablesmentioning

confidence: 99%

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Body fat distribution and its risk for cardiovascular events in 10 years: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

et al. 2022

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Body fat distribution seems to have different effects in cardiovascular diseases (CVD). We aimed to estimate the associations between lower limbs and trunk fat ratio and the 10-year CVD risk, and isolated risk factors in men and women. A total of 10,917 participants from ELSA-Brasil were eligible for this cross-sectional study. Associations between lower limb/trunk fat ratio with the percentage of 10-year CVD risk - according to the Framingham Risk Score - and its risk factors (systolic blood pressure, total cholesterol and HDL-cholesterol, diabetes, and use of antihypertensive medication) were performed using generalized linear models, linear and logistic regressions. All analyses were stratified by gender and adjustments were made by age, self-reported skin color, educational attainment, alcohol consumption, leisure physical activity, hypolipidemic drug use and, for women, menopausal status. In this study, 55.91% were women, with a mean age of 52.68 (SD = 6.57) years. A higher lower limb/trunk fat ratio was related to lower 10-year CVD risk, as well as a reduction in systolic blood pressure, total cholesterol, and antihypertensive drug use, also an increasing HDL-cholesterol in both genders, but this relationship was stronger in women. Besides, a protective relationship to diabetes was observed in women. Higher fat accumulation in the lower body, when compared to the trunk, seems to have a lower risk of CVD and associated risk factors - even in the presence of fat in the abdominal region - with women presenting lower risks than men.

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Section: Discussionmentioning

confidence: 88%

Section: Covariablesmentioning

confidence: 99%

Body fat distribution and its risk for cardiovascular events in 10 years: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

et al. 2022

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“…Randomized studies are underway with the aim of demonstrating that hormone replacement in postmenopausal women will be able to reduce CAD death rates. 16…”

Section: Resultsmentioning

confidence: 99%

Untitled

2020

JCCR

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Mini review In women, 46% of deaths result from cardiovascular disease (CVD) and 50% of them refer to coronary heart disease. Women, more than men, have angina pectomy as the initial manifestation of the disease (65% vs. 35%, respectively). Men, on the other hand, have acute myocardial infarction (AMI) as an initial manifestation in a higher proportion than in women (29% vs. 43%, respectively). The varied initial manifestations of ischemic diseases result in different diagnostic approaches; thus, as women report milder symptoms, despite a more severe disease, they are less submitted to diagnostic procedures, even having a positive stress test and, when they are, they are already in a more advanced state of the disease. 1-11 Once coronary heart disease is diagnosed in women, the rate of fatal cases exceeds that of men. Although most recurrent AMI occurs in men at a rate of 80% (perhaps because women are more likely to die after their first episode), the rate of reinfarction in women is also high. During the first 3 to 4years after AMI, approximately 20% of women will have a repeat of the episode.

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“…Furthermore, markers of vascular function, such as endothelial function and arterial stiffness, have shown improvement with ART. These positive changes in cardiovascular risk markers suggest a potential reduction in overall cardiovascular risk among menopausal women undergoing ART [49].…”

Section: Androgen Replacement Therapy and Its Potential Benefits For ...mentioning

confidence: 92%

The Impact of Menopause on Cardiovascular Aging: A Comprehensive Review of Androgen Influences

Raj,

Chakole,

Agrawal

et al. 2023

Cureus

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Menopause represents a critical life stage in women, characterized by hormonal changes that significantly impact cardiovascular health. While the decline in estrogen levels has long been recognized as a major contributor to cardiovascular aging in menopausal women, the role of androgens, particularly testosterone, has gained increasing attention in recent years. This comprehensive review aims to provide a thorough understanding of the impact of menopause on cardiovascular aging, with a specific focus on the influences of androgens.A literature search was conducted to gather relevant studies and clinical evidence exploring the relationship between menopause, androgens, and cardiovascular health. The review integrates findings from various studies to present a holistic view of the topic.The review outlines the changes in hormone levels during menopause and discusses the cardiovascular risk factors associated with this transition. Furthermore, it explores the impact of menopause on cardiovascular structure and function, elucidating the underlying mechanisms that contribute to cardiovascular aging. Androgens' significance in maintaining cardiovascular homeostasis is discussed, followed by exploring the effects of androgen decline during menopause on lipid profiles, insulin sensitivity, vascular function, and other cardiovascular parameters. The review delves into the mechanisms of androgen action on the cardiovascular system, emphasizing the role of androgen receptors and the intricate interplay between androgens, estrogens, and other hormones. Clinical evidence supporting the effects of androgens on cardiovascular aging is presented, including studies investigating the association between androgen levels and cardiovascular outcomes. Additionally, the impact of androgen replacement therapy (ART) on cardiovascular risk markers and events in menopausal women is examined, along with controversies and conflicting findings surrounding the use of androgen therapy in cardiovascular aging.This structured review provides a comprehensive understanding of the impact of menopause on cardiovascular aging, with a specific focus on the role of androgens. By highlighting the significance of androgens in cardiovascular health during menopause, this review aims to create an initial impression and interest among readers, inviting potential citations in the future. The findings underscore the need for further research and offer insights into managing cardiovascular aging in menopausal women, including lifestyle interventions, pharmacological approaches, and the potential role of personalized medicine and precision therapies.

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Cardiovascular Risk/Benefit Profile of MHT

Cited by 9 publications

References 94 publications

Body fat distribution and its risk for cardiovascular events in 10 years: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Body fat distribution and its risk for cardiovascular events in 10 years: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Untitled

The Impact of Menopause on Cardiovascular Aging: A Comprehensive Review of Androgen Influences

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