Hot flushes, coronary heart disease, and hormone therapy in postmenopausal women.
Hot flushes, coronary heart disease, and hormone therapy in postmenopausal women.
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DOI：
10.1097/gme.0b013e31819c11e4
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发表时间：
2009-07
期刊：
影响因子：
--
通讯作者：
Grady D
中科院分区：
文献类型：
--
作者：
Huang AJ;Sawaya GF;Vittinghoff E;Lin F;Grady D
本研究的目的是探讨绝经后女性冠心病患者潮热、雌激素加孕激素治疗（EPT）和冠心病（CHD）事件之间的相互作用。我们分析了来自心脏和雌激素/孕激素替代研究的数据，该研究是一项随机、安慰剂对照试验，在2,763名绝经后CHD妇女中使用0.625 mg结合型马雌激素加2.5 mg醋酸甲羟孕酮。在基线时使用自填式问卷评估潮热;认为在“一些”到“所有”时间报告令人烦恼的潮热的女性具有临床意义的潮红。考克斯回归模型用于研究EPT对基线时有或无明显潮红的女性冠心病事件风险的影响。参与者的平均年龄为66.7 ± 6.8岁，89%（n = 2，448）为白色。16%（n = 434）的参与者在基线时报告了具有临床意义的潮热。在基线潮红的女性中，与安慰剂相比，EPT在第一年增加了9倍的CHD事件风险（风险比= 9.01; 95% CI，1.15-70.35）;在基线无潮红的女性中，治疗对第一年的CHD事件风险无显著影响（对于潮热与治疗的相互作用，风险比= 1.32; 95% CI，0.86-2.03; P = 0.07）。EPT对基线潮红和无基线潮红的女性冠心病风险的差异效应的趋势在治疗第一年后并不持续。在患有CHD的绝经后老年妇女中，EPT可能会在治疗的第一年显著增加有临床意义的潮热的妇女发生CHD事件的风险，但不会增加没有潮热的妇女的风险。
The aim of this study was to examine interactions between hot flushes, estrogen plus progestogen therapy (EPT), and coronary heart disease (CHD) events in postmenopausal women with CHD. We analyzed data from the Heart and Estrogen/Progestin Replacement Study, a randomized, placebo-controlled trial of 0.625 mg conjugated equine estrogens plus 2.5 mg medroxyprogesterone acetate in 2,763 postmenopausal women with CHD. Hot flushes were assessed at baseline using self-administered questionnaires; women reporting bothersome hot flushes “some” to ”all” of the time were considered to have clinically significant flushing. Cox regression models were used to examine the effect of EPT on risk of CHD events among women with and without significant flushing at baseline. The mean age of participants was 66.7 ± 6.8 years, and 89% (n = 2,448) were white. Sixteen percent (n = 434) of participants reported clinically significant hot flushes at baseline. Among women with baseline flushing, EPT increased risk of CHD events nine-fold in the first year compared with placebo (hazard ratio = 9.01; 95% CI, 1.15-70.35); among women without baseline flushing, treatment did not significantly affect CHD event risk in the first year (hazard ratio = 1.32; 95% CI, 0.86-2.03; P = 0.07 for interaction of hot flushes with treatment). The trend toward differential effects of EPT on risk for CHD among women with and without baseline flushing did not persist after the first year of treatment. Among older postmenopausal women with CHD, EPT may increase risk of CHD events substantially in the first year of treatment among women with clinically significant hot flushes but not among those without hot flushes.
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影响因子：
12.7
作者：
Gold, Ellen B.;Colvin, Alicia;Matthews, Karen
通讯作者：
Matthews, Karen
影响因子：
37.8
作者：
Thurston RC;Sutton-Tyrrell K;Everson-Rose SA;Hess R;Matthews KA
通讯作者：
Matthews KA
DOI：
10.1097/gme.0b013e3180ca7cfa
发表时间：
2008-03-01
影响因子：
2.7
作者：
Low, David A.;Davis, Scott L.;Crandall, Craig G.
通讯作者：
Crandall, Craig G.
影响因子：
7.2
作者：
Barnabei, VM;Grady, D;Pickar, JH
通讯作者：
Pickar, JH
影响因子：
--
作者：
Huang, Alison J.;Grady, Deborah;Sawaya, George F.
通讯作者：
Sawaya, George F.