Ylikorkala O, Mikkola T
Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Finland.
Reprod Med Biol. 2005 Mar 7;4(1):1-6. doi: 10.1007/BF03016133. eCollection 2005 Mar.
Results from the recent randomized clinical trials indicating that hormone therapy (HT) does not provide cardiovascular protection, but potentially harm are in profound disagreement with the sound evidence from numerous observational and experimental studies. While the observational studies have mainly assessed symptomatic recently menopausal women, the randomized trials have studied symptomless elderly postmenopausal women with established coronary heart disease or various risk factors for cardiovascular disease. Therefore, the recent trials have only revealed that HT does not provide secondary cardiovascular benefits. Since primary cardiovascular benefits of HT are rational but not yet proven in clinical trials, new studies are in demand. Until more data from recently menopausal symptomatic women are available, we need to base our decisions on existing evidence and good clinical practice. Although the potential of HT to provide cardiovascular benefits is decreased by advancing age and time since menopause, this should not preclude the use of individualized HT in younger postmenopausal women. (Reprod Med Biol 2005; : 1- 6).
近期随机临床试验结果表明，激素疗法（HT）并不能提供心血管保护作用，反而可能有害，这与众多观察性和实验性研究的可靠证据存在严重分歧。观察性研究主要评估了近期有症状的绝经后女性，而随机试验研究的是患有已确诊冠心病或各种心血管疾病风险因素的无症状老年绝经后女性。因此，近期的试验仅表明HT不能提供继发性心血管益处。由于HT的原发性心血管益处虽合理，但尚未在临床试验中得到证实，所以需要开展新的研究。在获得更多来自近期有症状的绝经后女性的数据之前，我们需要依据现有证据和良好的临床实践来做决策。尽管随着年龄增长和绝经时间延长，HT提供心血管益处的潜力会降低，但这不应排除在较年轻的绝经后女性中使用个体化HT。（《生殖医学与生物学》2005年；：1 - 6）
