Bolton Judy L
Department of Medicinal Chemistry and Pharmacognosy (M/C 781) College of Pharmacy, University of Illinois at Chicago , 833 S. Wood St., Chicago, Illinois 60612-7231, United States.
Chem Res Toxicol. 2016 Oct 17;29(10):1583-1590. doi: 10.1021/acs.chemrestox.6b00272. Epub 2016 Sep 26.
The release of the Women's Health Initiative (WHI) study in 2002 was a shock to the medical community. Hormone therapy (HT) had generally been considered to be highly beneficial for postmenopausal women since it was the gold standard for relief of menopausal symptoms (hot flashes, night sweats, vaginal atrophy) and it was thought to protect women from osteoporosis, heart disease, and cognitive decline and to generally improve quality of life. However, WHI showed a statistically significant increase in a number of disease states, including breast cancer, cardiovascular disease, and stroke. One problem with the WHI study was that the average age of women in the study was 63, which is considerably older than the age at which most women enter menopause (about 51). The timing hypothesis attempts to rationalize the effect of age on response to HT and risk of various diseases. The data suggests that younger women (50-60) may be protected from heart disease with only a slight increase in breast cancer risk. In contrast, older women (>65) are more susceptible to breast cancer and heart disease and should avoid HT. This Perspective on Statistical Trends evaluates the current data on HT and risk for chronic diseases as a function of age.
2002年发布的女性健康倡议（WHI）研究震惊了医学界。激素疗法（HT）一直被普遍认为对绝经后女性非常有益，因为它是缓解更年期症状（潮热、盗汗、阴道萎缩）的金标准，而且人们认为它能保护女性免受骨质疏松症、心脏病和认知能力下降的影响，并总体上提高生活质量。然而，WHI研究表明，包括乳腺癌、心血管疾病和中风在内的多种疾病状态在统计学上有显著增加。WHI研究的一个问题是，研究中女性的平均年龄为63岁，这比大多数女性进入更年期时的年龄（约51岁）要大得多。时机假说试图解释年龄对HT反应和各种疾病风险的影响。数据表明，年轻女性（50 - 60岁）可能通过仅略微增加乳腺癌风险来预防心脏病。相比之下，老年女性（>65岁）更容易患乳腺癌和心脏病，应该避免使用HT。这篇关于统计趋势的观点文章评估了作为年龄函数的HT和慢性病风险的当前数据。
