Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
Menopause. 2021 Jul 19;28(9):1067-1069. doi: 10.1097/GME.0000000000001802.
The menopause transition is associated with adverse changes to the lipid profile. Although there are no specific treatment guidelines for women, current evidence supports the use of statin therapy in women with 1) established clinical atherosclerotic cardiovascular disease (ASCVD); 2) primary hypercholesterolemia, with low-density lipoprotein cholesterol of 190 mg/dL (4.9 mmol/L) or higher; 3) diabetes mellitus regardless of ASCVD risk category (ages 40-75 y); and 4) for primary prevention of ASCVD in women at high risk (10-y risk, ≥20%) or intermediate risk (10-y risk, ≥7.5-20%) with the presence of guideline-derived risk enhancers (age 40-75 y) such as premature menopause or a history of preeclampsia.
更年期过渡与血脂谱的不利变化有关。尽管目前尚无针对女性的特定治疗指南,但现有证据支持在以下情况下使用他汀类药物治疗女性:1)已确诊的临床动脉粥样硬化性心血管疾病(ASCVD);2)原发性高胆固醇血症,低密度脂蛋白胆固醇为 190mg/dL(4.9mmol/L)或更高;3)糖尿病,无论 ASCVD 风险类别如何(年龄 40-75 岁);以及 4)在高风险(10 年风险≥20%)或中风险(10 年风险≥7.5-20%)的女性中进行 ASCVD 的一级预防,同时存在指南衍生的风险增强剂(年龄 40-75 岁),如早发性绝经或先兆子痫病史。