6个月激素替代疗法与安慰剂对心血管系统的影响：与绝经年限相关的差异
Cardiovascular effects of 6 months of hormone replacement therapy versus placebo: differences associated with years since menopause.
作者信息
Brownley Kimberly A, Hinderliter Alan L, West Sheila G, Grewen Karen M, Steege John F, Girdler Susan S, Light Kathleen C
机构信息
Department of Psychiatry, University of North Carolina, Chapel Hill, 27599-7175, USA.
出版信息
Am J Obstet Gynecol. 2004 Apr;190(4):1052-8. doi: 10.1016/j.ajog.2003.09.045.
OBJECTIVE
In response to post-Women's Health Initiative dialog regarding individualized hormone replacement therapy (HRT), this study evaluates cardiovascular and neuroendocrine effects of HRT versus placebo in postmenopausal women grouped according to time since menopause.
STUDY DESIGN
Resting and stress blood pressure (BP), hemodynamic, plasma catecholamine, and cholesterol levels were obtained in 69 women randomly assigned to placebo or active HRT in a 6-month double-blind study. Analyses evaluated if treatment effects differed among those postmenopausal less than 5 years versus 5 years or more.
RESULTS
Compared with the placebo-treated and HRT > or =5 groups, the HRT < 5 group showed reduced BP (P<.0007) and trends toward reduced vascular resistance and norepinephrine (P<.07). HRT > or =5 group generally did not differ from placebo.
CONCLUSION
Reduced BP and sympathetic tone are evident in some HRT users, with diminishing benefit after the initial postmenopausal years. Time since menopause may be an important consideration in making individualized patient treatment decisions.
目的
针对妇女健康倡议（Women's Health Initiative）之后关于个体化激素替代疗法（HRT）的讨论，本研究评估了根据绝经时间分组的绝经后女性中HRT与安慰剂对心血管和神经内分泌的影响。
研究设计
在一项为期6个月的双盲研究中，对69名随机分配至安慰剂组或活性HRT组的女性，测量静息和应激状态下的血压（BP）、血流动力学、血浆儿茶酚胺和胆固醇水平。分析评估了绝经少于5年与5年及以上的女性中治疗效果是否存在差异。
结果
与安慰剂治疗组和HRT≥5年组相比，HRT<5年组血压降低（P<0.0007），血管阻力和去甲肾上腺素呈降低趋势（P<0.07）。HRT≥5年组与安慰剂组总体无差异。
结论
部分HRT使用者血压降低且交感神经张力降低，绝经后的最初几年后获益逐渐减少。绝经时间可能是做出个体化患者治疗决策时的重要考虑因素。
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