Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
Brain Res. 2011 Mar 16;1379:244-52. doi: 10.1016/j.brainres.2010.10.076. Epub 2010 Oct 25.
The totality of data indicates that the "window of opportunity" for reducing coronary heart disease (CHD) and overall mortality is initiation of hormone therapy (HT) within 6 years of menopause and/or before 60 years of age. Reduction of CHD risk and overall mortality with prolonged HT use in this subgroup of women is consistent across randomized controlled trials and observational studies. As such, HT use for 5 to 30 years in postmenopausal women who initiate HT in their 50s substantially increases quality-adjusted life-years (QALYs) by 1.5 QALYs and is highly cost-effective at $2438 per QALY gained. Cumulated randomized controlled trial results indicate a consistency along with observational data that young postmenopausal women with menopausal symptoms who use HT for long periods of time have lower rates of CHD and overall mortality than comparable postmenopausal women who do not use HT.
所有数据表明，降低冠心病（CHD）和总体死亡率的“机会之窗”是在绝经后 6 年内和/或 60 岁之前开始激素治疗（HT）。在这组女性中，延长 HT 使用时间可降低 CHD 风险和总体死亡率，这在随机对照试验和观察性研究中是一致的。因此，对于在 50 多岁开始 HT 的绝经后妇女，使用 HT 5 至 30 年可使 QALY 增加 1.5 个 QALY，每获得一个 QALY 的成本效益高达 2438 美元。累积的随机对照试验结果表明，与观察数据一致，有更年期症状的年轻绝经后妇女长期使用 HT 的 CHD 和总体死亡率低于不使用 HT 的可比绝经后妇女。
