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激素治疗时代后女性血脂异常的管理。

Management of dyslipidemia in women in the post-hormone therapy era.

作者信息

Mosca Lori

机构信息

Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.

出版信息

J Gen Intern Med. 2005 Mar;20(3):297-305. doi: 10.1111/j.1525-1497.2005.40239.x.

Abstract

OBJECTIVE

Cardiovascular disease (CVD) is the leading cause of death for women in the United States and is largely preventable. The American Heart Association has recently released evidence-based guidelines for the prevention of CVD in women; these include gender-specific recommendations for the management of dyslipidemia. This article reviews these recommendations and the evidence supporting them.

DESIGN

This was a qualitative review of a systematic literature search related to lipid guidelines for women and discussion of rationale and evidence for new clinical recommendations.

MAIN RESULTS

Lifestyle modifications are the cornerstone of lipid management. Substantial evidence from randomized clinical trials supports the use of low-density lipoprotein cholesterol-lowering therapy (primarily statins) in all high-risk women and the use of niacin or fibrates when high-density lipoprotein cholesterol is low or non-high-density lipoprotein cholesterol is elevated. Fewer data are available for women at lower or intermediate risk.

CONCLUSIONS

Encouragement of lifestyle modification and appropriate use of lipid-altering therapy will have a substantial impact on reducing the burden of cardiovascular disease in women.

摘要

目的

心血管疾病(CVD)是美国女性的首要死因,且在很大程度上是可预防的。美国心脏协会最近发布了基于证据的女性心血管疾病预防指南;其中包括针对血脂异常管理的性别特异性建议。本文回顾了这些建议及其支持证据。

设计

这是一项对与女性血脂指南相关的系统文献检索进行的定性综述,并讨论了新临床建议的基本原理和证据。

主要结果

生活方式改变是血脂管理的基石。随机临床试验的大量证据支持在所有高危女性中使用降低低密度脂蛋白胆固醇的疗法(主要是他汀类药物),以及在高密度脂蛋白胆固醇低或非高密度脂蛋白胆固醇升高时使用烟酸或贝特类药物。关于低风险或中度风险女性的数据较少。

结论

鼓励生活方式改变并适当使用改变血脂的疗法将对减轻女性心血管疾病负担产生重大影响。

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