Miller V T
George Washington University Medical Center, Lipid Research Center, Washington, DC.
Endocrinol Metab Clin North Am. 1990 Jun;19(2):381-98.
Heart disease is the number one cause of death in women, as it is in men; risk factors include high cholesterol, high triglycerides, low HDL-C, diabetes, hypertension, and cigarette smoking. Most of these factors are alterable. The lipoprotein profile of a woman undergoes many changes during her lifetime because of the effects of endogenous hormones at pregnancy, the administration of oral contraceptives, and estrogen replacement at the menopause. Endogenous estrogen reduces the risk of heart disease in women as does unopposed estrogen replacement in the menopause. Oral contraceptives, on the other hand, can increase risk depending on the dose prescribed. Careful attention to a woman's native lipid profile, as well as to the impact of administered hormones on her lipids, is important. It is the responsibility of the physician to help patients achieve and maintain the least atherogenic lipid profile possible as well as to identify and reduce other cardiovascular risk factors.
心脏病是女性的头号死因，对男性来说也是如此；风险因素包括高胆固醇、高甘油三酯、低高密度脂蛋白胆固醇、糖尿病、高血压和吸烟。这些因素大多是可以改变的。由于孕期内源性激素的影响、口服避孕药的使用以及绝经后雌激素替代治疗，女性的脂蛋白谱在一生中会发生许多变化。内源性雌激素以及绝经后单纯雌激素替代治疗可降低女性患心脏病的风险。另一方面，口服避孕药会根据所开剂量增加风险。密切关注女性自身的血脂情况以及所用激素对其血脂的影响非常重要。医生有责任帮助患者达到并维持尽可能低的致动脉粥样硬化血脂水平，并识别和降低其他心血管风险因素。
