Department of Obstetrics and Gynecology, Menopause and Osteoporosis Center, Pisa University Hospital, Pisa, Italy.
Climacteric. 2009;12 Suppl 1:32-5. doi: 10.1080/13697130903013445.
Climacteric complaints are the main indication for hormone replacement therapy (HRT) in the clinical practice. Observational studies demonstrating a protective effect of HRT on cardiovascular disease (CVD) were conducted in early menopausal, young, symptomatic women. Vasomotor symptoms correlate with lower level of plasma antioxidant activity, an increased cardiovascular reactivity to stressful situations, elevated cholesterol, higher sympathetic nerve activity, impaired flow-mediated dilation, hypertension and a higher risk of aortic calcification. All the available findings indicate that hot flushes can be seen as a marker for underlying vascular changes among mid-life, otherwise healthy, climacteric women. Thus, young, healthy symptomatic postmenopausal women differ from those without vasomotor symptoms with regard to cardiovascular risk factors. Therefore, responses to HRT can change in terms of cardiovascular outcomes according to the baseline vasomotor complaints. This point may explain, at least in part, the negative/null effects of HRT on cardiovascular disease observed in the trials where HRT was given to largely asymptomatic, elderly women.
更年期症状是临床中激素替代疗法（HRT）的主要适应证。在早期绝经、年轻、有症状的女性中进行的观察性研究表明，HRT 对心血管疾病（CVD）具有保护作用。血管舒缩症状与血浆抗氧化活性水平降低、对紧张情况的心血管反应性增加、胆固醇升高、交感神经活性升高、血流介导的扩张受损、高血压和主动脉钙化风险增加有关。所有现有研究结果表明，潮热可被视为中年健康更年期妇女潜在血管变化的标志物。因此，年轻、健康、有症状的绝经后女性与无血管舒缩症状的女性在心血管危险因素方面存在差异。因此，根据基线血管舒缩症状，HRT 的心血管结局反应可能会发生变化。这一点至少可以部分解释为什么在接受 HRT 的大量无症状、老年女性的试验中观察到 HRT 对心血管疾病无显著作用。
