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绝经早期与动脉高血压风险增加相关:系统评价和荟萃分析。

Early menopause is associated with increased risk of arterial hypertension: A systematic review and meta-analysis.

机构信息

1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece; Police Medical Center of Thessaloniki, Thessaloniki, Greece.

1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece; Police Medical Center of Thessaloniki, Thessaloniki, Greece.

出版信息

Maturitas. 2020 May;135:74-79. doi: 10.1016/j.maturitas.2020.03.006. Epub 2020 Mar 17.

Abstract

OBJECTIVE

Menopausal transition has been associated with an increased risk of cardiovascular disease (CVD), mainly attributed to atherogenic dyslipidaemia, central obesity and insulin resistance. Whether arterial hypertension (AH) also contributes to menopause-associated CVD is currently unknown. The aim of this study was to systematically investigate and meta-analyze the best available evidence regarding the association between early menopause (EM) and AH risk.

METHODS

A comprehensive search was conducted in PubMed, CENTRAL and Scopus databases, up to January 20th, 2020. Data were expressed as odds ratio (OR) with 95 % confidence intervals (CI). The I index was employed for heterogeneity.

RESULTS

Ten studies were included in the quantitative analysis (273,994 postmenopausal women, 76853 cases with AH). Women with EM (age at menopause <45 years) were at higher AH risk compared with those of normal age at menopause (>45 years) (OR 1.10, 95 % CI 1.01-1.19, p = 0.03; I 79 %). The direction or the magnitude of this association remained significant when the analysis was restricted to studies including groups matched for potential confounders, such as age, BMI, smoking or the use of menopausal hormone therapy or oral contraceptives.

CONCLUSIONS

Women with EM have an increased risk for AH compared with those of normal age at menopause.

摘要

目的

绝经期与心血管疾病(CVD)风险增加有关,主要归因于致动脉粥样硬化性血脂异常、中心性肥胖和胰岛素抵抗。目前尚不清楚动脉高血压(AH)是否也与绝经相关的 CVD 有关。本研究旨在系统地调查和荟萃分析有关早期绝经(EM)与 AH 风险之间关联的最佳现有证据。

方法

在 PubMed、CENTRAL 和 Scopus 数据库中进行了全面检索,检索时间截至 2020 年 1 月 20 日。数据以比值比(OR)及其 95%置信区间(CI)表示。采用 I 指数评估异质性。

结果

10 项研究被纳入定量分析(273994 名绝经后妇女,76853 例 AH)。与正常绝经年龄(>45 岁)的妇女相比,EM (绝经年龄<45 岁)的妇女发生 AH 的风险更高(OR 1.10,95%CI 1.01-1.19,p=0.03;I 79%)。当分析仅限于包括年龄、BMI、吸烟或使用绝经激素治疗或口服避孕药等潜在混杂因素匹配的组时,这种关联的方向或幅度仍然显著。

结论

与正常绝经年龄的妇女相比,EM 妇女发生 AH 的风险增加。

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