To compare the impact of oestrogen, gynaecological history, social support, li fe events and family history of CHD on psychosocial morbidity in syndrome X, CHD patients and healthy controls. 100 female syndrome X(60&#...To compare the impact of oestrogen, gynaecological history, social support, li fe events and family history of CHD on psychosocial morbidity in syndrome X, CHD patients and healthy controls. 100 female syndrome X(60±9 years), 100 female C HD(65±9 years) and 100 healthy female volunteers(61±10 years) completed the ho spital anxiety and depression scale(HADS), health anxiety questionnaire (HAQ), a demographic information scale, life events scale, family history of CHD, menopa usal, menstrual and gynaecological history. A 17β oestradiol sample was taken. Syndrome X patients had higher levels of life interference(p< 0.05) and HADS an xiety(p < 0.05) than CHD patients, and higher levels of all HADS and HAQ scales than controls (p< 0.01). Syndrome X patients with a large social network had low er HADS anxiety (p< 0.05), health worry (p< 0.05), life interference (p< 0.01) a nd total HAQ(p< 0.01). Social network (p=0.003), divorced/separated or widowed s tatus(p=0.005),HRT (p=0.008) and HADS anxiety score(p< 0.001) accounted for 41.9 %of the variance in HAQ scores in syndrome X. Oestrogen was unrelated to the HA DS or HAQ for any group. Syndrome X patients suffered higher levels of psycholog ical morbidity in comparison to CHD patients and controls. Life events and socia l network size were related to health anxiety, general anxiety and depression in women with syndrome X.展开更多
Background: The effect of raloxifene, a selective estrogen-receptor modulator, on coronary heart disease(CHD) and breast cancer is not established. Methods: We randomly assigned 10,101 postmenopausal women(mean age, 6...Background: The effect of raloxifene, a selective estrogen-receptor modulator, on coronary heart disease(CHD) and breast cancer is not established. Methods: We randomly assigned 10,101 postmenopausal women(mean age, 67.5 years) with CHD or multiple risk factors for CHD to 60 mg of raloxifene daily or placebo and followed them for a median of 5.6 years. The two primary outcomes were coronary events(i.e., death from coronary causes, myocardial infarction, or hospitalization for an acute coronary syndrome) and invasive breast cancer. Results: As compared with placebo, raloxifene had no significant effect on the risk of primary coronary events(533 vs. 553 events; hazard ratio, 0.95; 95 percent confidence interval, 0.84 to 1.07), and it reduced the risk of invasive breast cancer(40 vs. 70 events; hazard ratio, 0.56; 95 percent confidence interval, 0.38 to 0.83; absolute risk reduction, 1.2 invasive breast cancers per 1000 women treated for one year); the benefit was primarily due to a reduced risk of estrogen-receptor-positive invasive breast cancers. There was no significant difference in the rates of death from any cause or total stroke according to group assignment, but raloxifene was associated with an increased risk of fatal stroke(59 vs. 39 events; hazard ratio, 1.49; 95 percent confidence interval, 1.00 to 2.24; absolute risk increase, 0.7 per 1000 woman-years) and venous thromboembolism(103 vs. 71 events; hazard ratio, 1.44; 95 percent confidence interval, 1.06 to 1.95; absolute risk increase, 1.2 per 1000 woman-years). Raloxifene reduced the risk of clinical vertebral fractures(64 vs. 97 events; hazard ratio, 0.65; 95 percent confidence interval, 0.47 to 0.89; absolute risk reduction, 1.3 per 1000). Conclusions: Raloxifene did not significantly affect the risk of CHD. The benefits of raloxifene in reducing the risks of invasive breast cancer and vertebral fracture should be weighed against the increased risks of venous thromboembolism and fatal stroke.展开更多
文摘To compare the impact of oestrogen, gynaecological history, social support, li fe events and family history of CHD on psychosocial morbidity in syndrome X, CHD patients and healthy controls. 100 female syndrome X(60±9 years), 100 female C HD(65±9 years) and 100 healthy female volunteers(61±10 years) completed the ho spital anxiety and depression scale(HADS), health anxiety questionnaire (HAQ), a demographic information scale, life events scale, family history of CHD, menopa usal, menstrual and gynaecological history. A 17β oestradiol sample was taken. Syndrome X patients had higher levels of life interference(p< 0.05) and HADS an xiety(p < 0.05) than CHD patients, and higher levels of all HADS and HAQ scales than controls (p< 0.01). Syndrome X patients with a large social network had low er HADS anxiety (p< 0.05), health worry (p< 0.05), life interference (p< 0.01) a nd total HAQ(p< 0.01). Social network (p=0.003), divorced/separated or widowed s tatus(p=0.005),HRT (p=0.008) and HADS anxiety score(p< 0.001) accounted for 41.9 %of the variance in HAQ scores in syndrome X. Oestrogen was unrelated to the HA DS or HAQ for any group. Syndrome X patients suffered higher levels of psycholog ical morbidity in comparison to CHD patients and controls. Life events and socia l network size were related to health anxiety, general anxiety and depression in women with syndrome X.
文摘Background: The effect of raloxifene, a selective estrogen-receptor modulator, on coronary heart disease(CHD) and breast cancer is not established. Methods: We randomly assigned 10,101 postmenopausal women(mean age, 67.5 years) with CHD or multiple risk factors for CHD to 60 mg of raloxifene daily or placebo and followed them for a median of 5.6 years. The two primary outcomes were coronary events(i.e., death from coronary causes, myocardial infarction, or hospitalization for an acute coronary syndrome) and invasive breast cancer. Results: As compared with placebo, raloxifene had no significant effect on the risk of primary coronary events(533 vs. 553 events; hazard ratio, 0.95; 95 percent confidence interval, 0.84 to 1.07), and it reduced the risk of invasive breast cancer(40 vs. 70 events; hazard ratio, 0.56; 95 percent confidence interval, 0.38 to 0.83; absolute risk reduction, 1.2 invasive breast cancers per 1000 women treated for one year); the benefit was primarily due to a reduced risk of estrogen-receptor-positive invasive breast cancers. There was no significant difference in the rates of death from any cause or total stroke according to group assignment, but raloxifene was associated with an increased risk of fatal stroke(59 vs. 39 events; hazard ratio, 1.49; 95 percent confidence interval, 1.00 to 2.24; absolute risk increase, 0.7 per 1000 woman-years) and venous thromboembolism(103 vs. 71 events; hazard ratio, 1.44; 95 percent confidence interval, 1.06 to 1.95; absolute risk increase, 1.2 per 1000 woman-years). Raloxifene reduced the risk of clinical vertebral fractures(64 vs. 97 events; hazard ratio, 0.65; 95 percent confidence interval, 0.47 to 0.89; absolute risk reduction, 1.3 per 1000). Conclusions: Raloxifene did not significantly affect the risk of CHD. The benefits of raloxifene in reducing the risks of invasive breast cancer and vertebral fracture should be weighed against the increased risks of venous thromboembolism and fatal stroke.
