Miller Virginia M, Manson Joann E
Departments of Surgery and Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN.
Curr Cardiovasc Risk Rep. 2013 Jun 1;7(3):196-202. doi: 10.1007/s12170-013-0305-1.
Debate and controversy surrounding the benefits and risks of menopausal hormone therapy (MHT) for prevention of cardiovascular disease has continued in the decade since the cessation of the Women's Health Initiative (WHI) hormone therapy interventions. As a result, many women and their physicians have been reluctant to turn to MHT for relief of vasomotor and other menopausal symptoms. However, several follow-up studies of WHI participants provide additional insight into clinical characteristics of women who are more likely to have favorable outcomes and lower rates of adverse events associated with MHT. This report focuses on those studies that identify characteristics and biomarkers helpful in stratifying risk for an individual. Incorporation of these factors into a benefit:risk model could assist in patient-oriented decision making regarding use of MHT. Personalizing treatment offers the potential to minimize risk and improve health outcomes.
自妇女健康倡议(WHI)激素治疗干预措施停止后的十年里,围绕绝经激素治疗(MHT)预防心血管疾病的益处和风险的争论与争议一直持续。因此,许多女性及其医生都不愿采用MHT来缓解血管舒缩及其他绝经症状。然而,对WHI参与者的几项随访研究为更有可能获得良好结果且与MHT相关不良事件发生率较低的女性的临床特征提供了更多见解。本报告重点关注那些确定有助于对个体风险进行分层的特征和生物标志物的研究。将这些因素纳入益处-风险模型有助于在使用MHT方面进行以患者为导向的决策。个性化治疗有可能将风险降至最低并改善健康结果。