Menopause, atherosclerosis, and coronary artery disease

Barrett‐Connor, Elizabeth

doi:10.1016/j.coph.2013.01.005

Cited by 97 publications

(70 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a study comparing testosterone-treated FtoM with hyperandrogenic women with polycystic ovarian syndrome, we found that testosterone administration induced a decline in serum HDL and increase in triglycerides, but had no effect on insulin resistance, a frequent feature of PCOS (54). Remarkably, cohort studies of premenopausal women followed through the menopause transition suggest that women with oophorectomy are at greater risk for coronary heart disease than intact women, pointing to a greater risk from deficiency of testosterone produced by the postmenopausal ovary than from reduced postmenopausal estradiol levels (61). In summary, it is difficult to establish definitively negative effects of testosterone on cardiovascular disease in females.…”

Section: The Effects Of Testosterone Administration On Cardiovascularmentioning

confidence: 63%

Cardiovascular disease in transsexual persons treated with cross-sex hormones: reversal of the traditional sex difference in cardiovascular disease pattern

Gooren

Wierckx

Giltay

2014

European Journal of Endocrinology

112

View full text Add to dashboard Cite

Objective: The incidence of heart disease increases with age, but is lower in women than in men up to 75 years. A protective effect of female sex hormones or, alternatively, acceleration in male heart disease by testosterone at younger ages, could explain this sex difference. In contrast with the above, male-to-female transsexual subjects (MtoF) treated with estrogens (Canti-androgens) show more cardiovascular pathology than female-to-male transsexual subjects (FtoM) receiving testosterone. Why MtoF suffer more frequently from cardiovascular disease than females is as yet unclear. The mode of cross-sex hormone treatment may be a factor, and, if so, it may need adaptations. Subjects and methods: Studies in transsexual people on the effects of cross-sex hormone treatment on surrogate cardiovascular risks and on clinical endpoints were reviewed. With regard to MtoF, a parallel was sought with men with prostate cancer, undergoing androgen deprivation and estrogen administration. Results: Exposure of FtoM to testosterone was not associated with a strong increase in cardiovascular events. Aging and pre-existing cardiovascular pathology contributed to the risk of cardiovascular disease in MtoF. Use of the synthetic biopotent compound ethinyl estradiol in a dose two to four times of oral contraceptives increased cardiovascular risk substantially. The route of administration of estrogens (oral vs transdermal) may have impacted on the risks. Conclusion: MtoF should not be treated with oral ethinyl estradiol. Transdermal estrogens are probably safer than oral estrogens. Pre-existing cardiovascular risks should be taken into consideration when prescribing and choosing the type of estrogens in crosssex hormone administration (oral vs transdermal). In addition, risk factors, as they emerge with aging, should be addressed.

show abstract

Section: The Effects Of Testosterone Administration On Cardiovascularmentioning

confidence: 63%

Cardiovascular disease in transsexual persons treated with cross-sex hormones: reversal of the traditional sex difference in cardiovascular disease pattern

Gooren

Wierckx

Giltay

2014

European Journal of Endocrinology

112

View full text Add to dashboard Cite

show abstract

“…Additionally, the suggestions that changing hormone levels through menopause were responsible for this increased risk are disputed in a recent and comprehensive narrative synthesis of the menopause and CHD which indicates that age-related changes in weight, blood pressure, cholesterol and waist, determine hormonal changes and the age of menopause and not vice versa [52].…”

Section: Discussionmentioning

confidence: 99%

Dietary fibre and cardiovascular disease mortality in the UK Women’s Cohort Study

et al. 2013

View full text Add to dashboard Cite

Objectives and Background: Dietary fibre has been associated with improvements in key risk factors for cardiovascular disease (CVD). Prior research has focussed more on CVD development in men andour aim was therefore to explore the association between dietary fibre intake and CVD mortality using data from the United Kingdom Women's Cohort Study (UKWCS).Methods and results: Dietary fibre intake from 31,036 women was calculated both as non-starch polysaccharide (NSP) and using the Association of Official Analytical Chemist (AOAC) method from food-frequency questionnaires. Participants were free from history of CVD at baseline and mean age at recruitment was 51.8 years (standard deviation 9.2). Mortality records for participants were linked from national registry data and 258 fatal CVD cases (130 stroke, 128 coronary heart disease (CHD)) were observed over an average follow-up period of 14.3 years.Total dietary fibre (NSP/AOAC) or fibre from different food sources were not associated with reduced fatal CHD, stroke or CVD risk in the full sample. For every 6g/day increase in NSP, the hazard ratio (HR) was 0.91 (95%Confidence Interval (CI) 0.76 to 1.08) or for every 11g/day increase in fibre assessed as AOAC, the HR was 0.92 (95% CI 0.80 to 1.05). Sensitivity analyses suggest a possible protective association for cereal sources of fibre on fatal stroke risk in overweight women, 0.80 (95%CI 0.65 to 0.93) p<0.01 and for fibre density and fatal stroke in women free of hypertension or angina 0.83 (95% CI 0.70 to 0.99) p=0.04Conclusions: In the UKWCS, a sample of health-conscious women, greater dietary fibre intake may confer no additional cardiovascular benefit, in terms of mortality, but may contribute to lower fatal stroke risk in those free of cardiovascular risk factors (hypertension/angina) or overweight women who consume greater cereal fibre.

show abstract

“…Disentangling intertwined effects of chronological and reproductive aging on CVD risk in women has proven challenging(50) (51) (52). Select findings from large-scale US general population CVD research studies imply, indirectly, that robust and sustained endogenous estrogen production may protect women against CVD.…”

Section: Sex-specific Mechanisms Underlying Heightened Cvd Risk Amongmentioning

confidence: 99%

Cardiovascular disease risk among women living with HIV in North America and Europe

Stone

Looby

Zanni

2017

Current Opinion in HIV and AIDS

View full text Add to dashboard Cite

Purpose of review To examine the epidemiology and mechanistic underpinnings of heightened cardiovascular disease (CVD) risk among women living with HIV (WLHIV) in North America and Europe. Recent Findings WLHIV in North America and Europe exhibit high CVD incidence rates, on par with those of compatriot men living with HIV (MLHIV). Compared with uninfected women, WLHIV in these regions face a two- to four-fold increased relative risk for myocardial infarction (MI), stroke, and heart failure. HIV-associated CVD risk is fuelled by a negative synergy of traditional cardiometabolic risk factors and heightened systemic immune activation/inflammation. Among WLHIV, female sex and endogenous sex hormone production influence both traditional cardiometabolic risk factors and patterns of systemic immune activation/inflammation. WLHIV in North America and Europe may also experience heightened CVD risk in relation to a relatively increased prevalence of behavioral and psychosocial CVD risk factors, coupled with suboptimal therapeutic targeting of known traditional cardiometabolic risk factors. Summary Additional research on sex-specific mechanisms of HIV-associated CVD - based not only out of North America and Europe but also and especially out of Africa, Asia, and South America - will inform the development of CVD prediction algorithms and prevention guidelines clinically relevant to the 17 million women aging with HIV globally.

show abstract

Menopause, atherosclerosis, and coronary artery disease

Cited by 97 publications

References 25 publications

Cardiovascular disease in transsexual persons treated with cross-sex hormones: reversal of the traditional sex difference in cardiovascular disease pattern

Cardiovascular disease in transsexual persons treated with cross-sex hormones: reversal of the traditional sex difference in cardiovascular disease pattern

Dietary fibre and cardiovascular disease mortality in the UK Women’s Cohort Study

Cardiovascular disease risk among women living with HIV in North America and Europe

Contact Info

Product

Resources

About