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绝经激素治疗与绝经后妇女高血压有关:观察性队列研究。

Menopausal hormone therapy is associated with having high blood pressure in postmenopausal women: observational cohort study.

机构信息

School of Medicine, University of Western Sydney, Penrith, New South Wales, Australia.

出版信息

PLoS One. 2012;7(7):e40260. doi: 10.1371/journal.pone.0040260. Epub 2012 Jul 11.

Abstract

BACKGROUND

The relationship between menopausal hormone therapy (MHT) and cardiovascular risk remains controversial, with a number of studies advocating the use of MHT in reducing risk of cardiovascular diseases, while others have shown it to increase risk. The aim of this study was to determine the association between menopausal hormone therapy and high blood pressure.

METHODS AND FINDINGS

A total of 43,405 postmenopausal women were included in the study. Baseline data for these women were sourced from the 45 and Up Study, Australia, a large scale study of healthy ageing. These women reported being postmenopausal, having an intact uterus, and had not been diagnosed with high blood pressure prior to menopause. Odds ratios for the association between MHT use and having high blood pressure were estimated using logistic regression, stratified by age (<56 years, 56-61 years, 62-70 years and over 71 years) and adjusted for demographic and lifestyle factors. MHT use was associated with higher odds of having high blood pressure: past menopausal hormone therapy use: <56 years (adjusted odds ratio 1.59, 99% confidence interval 1.15 to 2.20); 56-61 years (1.58, 1.31 to 1.90); 62-70 years (1.26, 1.10 to 1.44). Increased duration of hormone use was associated with higher odds of having high blood pressure, with the effect of hormone therapy use diminishing with increasing age.

CONCLUSIONS

Menopausal hormone therapy use is associated with significantly higher odds of having high blood pressure, and the odds increase with increased duration of use. High blood pressure should be conveyed as a health risk for people considering MHT use.

摘要

背景

绝经激素治疗(MHT)与心血管风险之间的关系仍存在争议,许多研究主张使用 MHT 降低心血管疾病的风险,而其他研究则表明它会增加风险。本研究旨在确定绝经激素治疗与高血压之间的关系。

方法和发现

共有 43405 名绝经后妇女纳入研究。这些妇女的基线数据来自澳大利亚的 45 岁及以上研究,这是一项关于健康老龄化的大规模研究。这些妇女报告绝经后、子宫完整,且在绝经前未被诊断为高血压。使用逻辑回归估计 MHT 使用与高血压之间的关联的优势比,按年龄(<56 岁、56-61 岁、62-70 岁和>71 岁)分层,并调整了人口统计学和生活方式因素。MHT 使用与高血压的发生风险增加相关:过去绝经激素治疗的使用:<56 岁(调整后的优势比 1.59,99%置信区间 1.15 至 2.20);56-61 岁(1.58,1.31 至 1.90);62-70 岁(1.26,1.10 至 1.44)。激素使用持续时间的增加与高血压发生风险的增加相关,随着年龄的增加,激素治疗的效果逐渐减弱。

结论

绝经激素治疗的使用与高血压的发生风险显著相关,并且随着使用时间的增加,这种相关性增加。对于考虑使用 MHT 的人,应告知高血压是一种健康风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13f8/3394783/68c2f18bde24/pone.0040260.g001.jpg

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