Stanford Prevention Research Center, Stanford University School of Medicine, Medical School Office Building, 251 Campus Drive, Room X308, Stanford, CA 94305-5411, United States.
Nutr Metab Cardiovasc Dis. 2010 Jul;20(6):451-8. doi: 10.1016/j.numecd.2010.02.015. Epub 2010 May 31.
The belief in the hypothesis of cardiovascular benefit of hormone therapy (HT) in postmenopausal women was widespread; however, the Women's Health Initiative (WHI) hormone trials found no evidence of coronary heart disease (CHD) benefit among women aged 50-79 with no prior CHD diagnosis and HT increased risk of stroke. This article reviews the literature regarding HT and CHD, with emphasis on the findings from the WHI trials.
Findings from observational studies and animal studies addressing biological plausibility that had been interpreted as evidence to support the use of HT were reviewed and findings from the trials of women with cardiovascular disease and the WHI hormone trials are summarized, with specific commentary on the issue of differential effects of HT in younger versus older women.
HT should not be prescribed for the purpose of preventing cardiovascular disease. The WHI offered support for the current U.S. Food and Drug Administration recommendation to limit HT to short-term use. There is a clear need for a greater understanding of the effects of both endogenous and exogenous estrogens in relationship to the aging cardiovascular system.
人们普遍相信激素疗法（HT）对绝经后妇女心血管有益的假说；然而，妇女健康倡议（WHI）激素试验并未发现无先前冠心病诊断且正在接受 HT 的 50-79 岁女性的冠心病获益证据，且 HT 增加了中风风险。本文综述了关于 HT 和冠心病的文献，重点关注 WHI 试验的结果。
对观察性研究和动物研究的结果进行了回顾，这些研究涉及生物学上的合理性，这些结果被解释为支持使用 HT 的证据，并总结了患有心血管疾病的女性和 WHI 激素试验的研究结果，特别评论了 HT 在年轻女性和老年女性中作用效果的差异问题。
不应为预防心血管疾病而开 HT 处方。WHI 支持美国食品和药物管理局目前的建议，即限制 HT 的短期使用。显然需要更深入地了解内源性和外源性雌激素与衰老心血管系统的关系的影响。
