Hormone replacement therapy for preventing cardiovascular disease in post-menopausal women

Gabriel, Sanchez R; Figuls, Marta Roqué i; Sanchez, Gomez LM; Soares, Karla Vanessa Souza; Calaf, Joaquím; Bonfill, Xavier

doi:10.1002/14651858.cd002229

Cited by 15 publications

(13 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…21 In the present study, reduced GFR was associated with a high risk of stroke in men after adjustment for demographic factors but not after adjustment for potential confounding factors; however, this relationship was still observed in women even after adjustment for confounding factors. This sex difference may be a consequence of the effects of residual confounding factors, specifically, hypercoagulable states 22 or gonadal steroids, 23 in women. Furthermore, the lack of a significant association between reduced GFR and a high risk of myocardial infarction is probably due to the relatively small number of events.…”

Section: Discussionmentioning

confidence: 99%

Impact of Kidney Disease and Blood Pressure on the Development of Cardiovascular Disease

et al. 2008

View full text Add to dashboard Cite

Background-Kidney disease is associated with an increased risk of cardiovascular disease (CVD); however, there have been few well-designed prospective studies of this issue in Asian populations. Recent epidemiological studies have suggested that a lower blood pressure level may be associated with an increased risk of CVD in individuals with kidney dysfunction. Methods and Results-Using data from 10 community-based cohort studies in Japan, we conducted follow-up on a total of 30 657 individuals 40 to 89 years of age without preexisting CVD or kidney failure and examined the relationship between reduced glomerular filtration rate (GFR) and the risk of CVD. During an average 7.4-year follow-up, 727 individuals experienced CVD. The age-and sex-adjusted incidence of CVD increased significantly in subjects with GFR of 60 to 89 mL · min Ϫ1 · 1.73 m Ϫ2 (4.3 per 1000 person-years, Pϭ0.002) and in those with a GFR Ͻ60 mL · min Ϫ1 · 1.73 m Ϫ2 (6.5, PϽ0.001) compared with those with a GFR Ն90 mL · min Ϫ1 · 1.73 m Ϫ2 (2.9). Even after adjustment for potential confounding factors, subjects with a GFR Ͻ60 mL · min Ϫ1 · 1.73 m Ϫ2 had a 57% (95% CI 14% to 115%) greater risk of CVD than those with a GFR Ն90 mL · min Ϫ1 · 1.73 m Ϫ2 . The multivariate-adjusted hazard ratios of CVD increased in a log-linear manner with elevations in blood pressure levels, regardless of GFR levels (all P for trend Ͻ0.01). Conclusions-Our findings suggest that a reduced GFR is a significant risk factor for CVD in the general Japanese population. Additionally, a log-linear association of blood pressure level with CVD risk was observed, without evidence of a J-curve association, regardless of GFR levels.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of Kidney Disease and Blood Pressure on the Development of Cardiovascular Disease

et al. 2008

View full text Add to dashboard Cite

show abstract

“…These results are incongruous with most other studies, observational 2 3 as well as randomised. [18][19][20] This may be due to the differences in the administered hormones; 17-β-estradiol has been reported to be less thrombogenic than conjugated equine oestrogen. 21 22 In human aortic endothelial cells 17-β-estradiol is superior to conjugated equine oestrogen in increasing the production of nitric oxide, partially because of a higher ability to activate the production of endothelial nitric oxide synthase.…”

Section: Thromboembolismmentioning

confidence: 99%

Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial

Schierbeck

Rejnmark

Tofteng

et al. 2012

BMJ

614

341

View full text Add to dashboard Cite

Objective To investigate the long term effect of hormone replacement therapy on cardiovascular outcomes in recently postmenopausal women.Design Open label, randomised controlled trial.Setting Denmark, 1990-93. Participants 1006 healthy women aged 45-58 who were recently postmenopausal or had perimenopausal symptoms in combination with recorded postmenopausal serum follicle stimulating hormone values. 502 women were randomly allocated to receive hormone replacement therapy and 504 to receive no treatment (control). Women who had undergone hysterectomy were included if they were aged 45-52 and had recorded values for postmenopausal serum follicle stimulating hormone. InterventionsIn the treatment group, women with an intact uterus were treated with triphasic estradiol and norethisterone acetate and women who had undergone hysterectomy received 2 mg estradiol a day. Intervention was stopped after about 11 years owing to adverse reports from other trials, but participants were followed for death, cardiovascular disease, and cancer for up to 16 years. Sensitivity analyses were carried out on women who took more than 80% of the prescribed treatment for five years.Main outcome measure The primary endpoint was a composite of death, admission to hospital for heart failure, and myocardial infarction.

show abstract

“…However, recent studies found an increased risk of breast cancer, heart attacks and strokes in patients on HRT. [2][3][4][5] In view of this, patients increasingly access alternative, non-hormonal treatment for menopausal symptoms. 6 Anumber of reviews of the effectiveness of complementary therapies for hot flushes have been published.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture and Self Acupuncture for Long Term Treatment of Vasomotor Symptoms in Cancer Patients - Audit and Treatment Algorithm

Filshie

Bolton²,

Browne

et al. 2005

Acupunct Med

View full text Add to dashboard Cite

Introduction Since hormone replacement therapy given for long periods is now recognised to produce serious side effects, patients with troublesome vasomotor symptoms are increasingly using non-hormonal treatment including acupuncture. Several randomised controlled trials have shown that acupuncture reduces menopausal symptoms in patients experiencing the normal climacteric. It may have this effect by raising serotonin levels which alter the temperature set point in the hypothalamus. Va somotor symptoms can be extreme in breast cancer patients and patients with prostate cancer who are undergoing anticancer therapy. The safety of some herbal medicines and phytoestrogens has been questioned, as they could potentially interfere adversely with the bioavailability of tumouricidal drugs. Aprevious study reports short term benefit from acupuncture, and the aim of this report is to describe our approach to long term treatment. Acupuncture approach After piloting several approaches, six weekly treatments were given initially at LI4, TE5, LR3 and SP6 and two upper sternal points, but avoiding any limb with existing lymphoedema or prone to developing it. If there were no contraindications, patients were given clear instructions on how to perform self acupuncture using either semi-permanent needles or conventional needling at SP6, weekly for up to six years, for long term maintenance. Audit methods and results Aretrospective audit of electronic records was carried out by a doctor not involved in treatment. Atotal of 194 patients were treated, predominantly with breast and prostate cancer. One hundred and eighty two patients were female. The number of pre-treatment hot flushes per day was estimated by the patient: in the 159 cases providing adequate records, the mean was 16 flushes per day. Following treatment, 114 (79%) gained a 50% or greater reduction in hot flushes and 30 (21%) a less than 50% reduction. Treatment was abandoned in those who responded poorly or not at all. The duration of treatment varied from one month to over six years with a mean duration of nine months. Seventeen patients (9%) experienced minor side effects over the six year period, mostly minor rashes; one patient described leg swelling but this was likely to be due to a concurrent fracture. Conclusion Acupuncture including self acupuncture is associated with long term relief of vasomotor symptoms in cancer patients. Treatment is safe and costs appear to be low. An algorithm is presented to guide clinical use. We recommend the use of self acupuncture with needles at SP6 in preference to semipermanent needles in the first instance, but poor responders use indwelling studs if they fail to respond adequately to self acupuncture with regular needles. Point location may be of less importance than the overall 'dose', and an appropriate minimum dose may be required to initiate the effect.

show abstract

Hormone replacement therapy for preventing cardiovascular disease in post-menopausal women

Cited by 15 publications

References 8 publications

Impact of Kidney Disease and Blood Pressure on the Development of Cardiovascular Disease

Impact of Kidney Disease and Blood Pressure on the Development of Cardiovascular Disease

Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial

Acupuncture and Self Acupuncture for Long Term Treatment of Vasomotor Symptoms in Cancer Patients - Audit and Treatment Algorithm

Contact Info

Product

Resources

About