Menopause does not affect blood pressure and risk profile, and menopausal women do not become similar to men
Menopause does not affect blood pressure and risk profile, and menopausal women do not become similar to men
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DOI：
10.1097/hjh.0b013e32830bfdd9
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发表时间：
2008-10-01
影响因子：
4.9
通讯作者：
Pessina, Achille C.
中科院分区：
文献类型：
--
作者：
Casiglia, Edoardo;Tikhonoff, Valerie;Pessina, Achille C.
客观更年期被认为是心血管危险因素，但这种信念是基于观点而不是证据。年龄的混杂影响经常被忽视。设计基于人群的研究，对年龄匹配的男性和生育期及更年期女性的逐例年龄匹配队列进行进一步亚分析。将流行病学置于初级、公共、机构框架中。参与者 9,364 岁的 18-70 岁男性和女性代表意大利一般人群，随访时间为 18.8 +/- 7.7 年。主要结果指标血压 (BP)、高血压的患病率和发病率、血清总胆固醇、高密度脂蛋白和低密度脂蛋白胆固醇、葡萄糖耐量、身体肥胖、血管反应性、靶器官损伤、总体和心血管死亡率和发病率（按性别和绝经状态）。 结果 横断面：粗血压、对寒冷的升压反应、直立性血压降低、BMI、皮褶厚度、空腹和负荷后血糖和胰岛素、血脂、左心室质量、血清肌酐、绝经期女性的微量白蛋白尿和增强指数高于育龄女性，并且绝经期女性和男性的水平相当，但在调整年龄或考虑年龄匹配的数学队列时，这种差异不再存在。纵向：随访期间血压升高、心血管死亡率和发病率在绝经期女性中高于生育期女性，并且在绝经期女性和男性中具有可比性，但在年龄匹配的队列中不再存在差异。包括年龄在内的多变量 Cox 分析拒绝了更年期状态。 结论 通常归因于更年期的心血管影响似乎仅仅是更年期妇女年龄较大的结果。
Objective Menopause is considered to be a cardiovascular risk factor, but this belief is based on opinions rather than on evidence. Confounding effects of age are often neglected.Design Population-based study with further subanalysis of case-to-case age-matched cohorts of men and fertile and menopausal women.Setting Epidemiology in primary, public, institutional frame.Participants Nine thousand three hundred and sixty-four men and women aged 18-70 years representative of Italian general population followed-up for 18.8 +/- 7.7 years.Main outcome measures Blood pressure (BP), prevalence and incidence of hypertension, serum total, high-density lipoprotein and low-density lipoprotein cholesterol, glucose tolerance, body adiposity, vascular reactivity, target organ damage, overall and cardiovascular mortality and morbidity, by gender and by menopausal status.Results Cross-sectional: crude BP, pressor response to cold, orthostatic BP decrease, BMI, skinfold thickness, fasting and postload blood glucose and insulin, serum lipids, left ventricular mass, serum creatinine, microalbuminuria and augmetantion index were higher in menopausal than in fertile women, and comparable in menopausal women and men, a difference that was no longer present when adjusting for age or considering age-matched mathced cohorts. Longitudinal: BP increase during follow-up, cardiovascular mortality and morbidity were greater in menopausal than in fertile women, and comparable in menopausal women and men, a difference no longer present in age-matched cohorts. Menopausal status was rejected from multivariate Cox analysis also including age.Conclusion The cardiovascular effects usually attributed to menopause seem to be a mere consequence of the older age of menopausal women.