雌激素、激素替代疗法与心血管疾病

Estrogen,Hormonal Replacement Therapy and Cardiovascular Disease

与年龄匹配的男性相比,绝经前女性有较低的高血压及心血管疾病风险及发病率,这种年龄优势在绝经后逐渐消失,表明了雌激素的心脏保护作用。然而,随机前瞻性研究否定了激素替代疗法对心血管疾病的一级及二级预防作用。指出上述分歧的原因,同时揭示激素替代疗法在防治年轻或绝经前女性与绝经后女性心血管疾病方面利弊差异的原因。

Premenopausal women have lower risk and incidence of hypertension and cardiovascular disease（CVD） compared to age-matched men and this sex advantage for women gradually disappears after menopause,suggesting that sexual hormones play a cardioprotective role in women.However,randomized prospective primary or secondary prevention trials failed to confirm that hormone replacement therapy（HRT） affords cardioprotection.This review highlights the factors that may contribute to this divergent outcome and could reveal why young or premenopausal women are protected from CVD and yet postmenopausal women do not benefit from HRT.