No association of menopause and hormone replacement therapy with carotid artery intima-media thickness. Atherosclerosis Risk in Communities (ARIC) Study Investigators.
No association of menopause and hormone replacement therapy with carotid artery intima-media thickness. Atherosclerosis Risk in Communities (ARIC) Study Investigators.
复制标题
绝经和激素替代治疗与颈动脉内膜中层厚度没有关联。
DOI：
10.1161/01.cir.94.8.1857
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发表时间：
1996
期刊：
影响因子：
37.8
通讯作者：
Heiss,G
中科院分区：
文献类型：
--
作者：
Nabulsi,AA;Folsom,AR;Szklo,M;White,A;Higgins,M;Heiss,G
背景心血管疾病是老年妇女死亡的主要原因。绝经和激素替代治疗与颈动脉粥样硬化的关系的信息是limited.Methods and ResultsWe检查横截面的绝经状态，自上次月经以来的年，和激素替代治疗状态与颈动脉内膜中层厚度的关联，确定由B型超声。在社区动脉粥样硬化风险研究中，没有症状性心血管疾病史的女性参与者（n=5436）被纳入分析。从未使用激素替代疗法的45- 54岁女性的绝经状态与颈动脉内膜中层厚度没有强相关性（绝经前和绝经后妇女的平均值分别为0.65 mm和0.67 mm，调整了年龄、种族、吸烟年数、体重指数、运动指数、收缩压、血压药物的使用、饮酒状况、糖尿病，教育水平）。年龄在55 - 64岁的绝经后妇女中，距上次月经≤5年的妇女校正后平均内膜-中膜厚度（0.74 mm）与距上次月经>5年的妇女（0.75 mm）相当（P> 0.05）。尽管激素替代疗法的使用与更有利的血脂和止血特征相关，但其使用与年龄在55至64岁的绝经后妇女的内膜中层厚度无关（调整后的平均值=0.74 mm，对于当前单独使用雌激素的使用者，以及对于当前使用雌激素加阿司汀的使用者，和从来没有用户）。ConclusionsThe数据表明，众所周知的协会激素替代治疗减少动脉粥样硬化性心血管疾病可能更多地归因于急性生理效应，如血液动力学变化或减少血栓形成，而不是动脉粥样硬化本身。
BackgroundCardiovascular disease is the major cause of death in older women. Information on the relation of menopause and hormone replacement therapy with carotid atherosclerosis is limited.Methods and ResultsWe examined cross-sectionally the association of menopausal status, years since last menstruation, and hormone replacement therapy status with carotid artery intima-media thickness as determined by B-mode ultrasound. Female participants (n=5436) in the Atherosclerosis Risk in Communities Study without a history of symptomatic cardiovascular disease were included in the analyses. Menopause status in 45- to 54-year-old women who had never used hormone replacement therapy was not strongly associated with carotid intima-media thickness (mean=0.65 mm and 0.67 mm in premenopausal and postmenopausal women, respectively, adjusted for age, race, cigarette years of smoking, body mass index, sport index, systolic blood pressure, use of blood pressure medications, drinking status, diabetes, and education level). In postmenopausal women aged 55 to 64 years, women with ≤5 years since last menstruation had an adjusted average intima-media thickness (0.74 mm) comparable to those with >5 years since last menstruation (0.75 mm) (P>.05). Although hormone replacement therapy use was associated with a more favorable lipid and hemostasis profile than nonuse, its use was not associated with intima-media thickness in postmenopausal women aged 55 to 64 years (adjusted average=0.74 mm for current users of estrogen alone and ≈0.75 mm each for current users of estrogen plus progestin, former users, and never users).ConclusionsThe data suggest that the well-known associations of hormone replacement therapy with reductions in atherosclerotic cardiovascular disease may be attributable more to acute physiological effects, such as hemodynamic changes or reduced thrombosis, than to atherosclerosis itself.