Barrett-Connor E
Department of Family and Preventive Medicine, University of California, San Diego, La Jolla 92093-0607.
Fertil Steril. 1994 Dec;62(6 Suppl 2):127S-132S.
To consider why women have less heart disease than men and to review the relation of heart disease risk factors, menopause, and estrogen to the risk for heart disease in women.
A review of illustrative publications.
Women have less heart disease than men at any given level of every major risk factor, with the possible exception of diabetes, even when the relative risk associated with that risk factor is similar for both sexes. Endogenous estrogen is a plausible explanatory variable, but no studies have shown that it is protective. Estrogen treatment after the menopause appears to reduce women's risk for heart disease, but no clinical trials have been reported that prove the benefit of this or any other intervention, except blood pressure control, in women.
Prevention programs can safely recommend nonpharmacologic interventions that reflect the evolutionary norm, such as better diet, more exercise, and not smoking. Pharmacologic interventions to prevent disease require clinical trials.
探讨女性心脏病发病率低于男性的原因，并综述心脏病风险因素、绝经及雌激素与女性心脏病风险之间的关系。
对相关代表性出版物进行综述。
在每一项主要风险因素的任何给定水平下，女性患心脏病的几率均低于男性，但糖尿病可能是个例外，即便某一风险因素对两性的相对风险相似。内源性雌激素是一个合理的解释变量，但尚无研究表明其具有保护作用。绝经后进行雌激素治疗似乎可降低女性患心脏病的风险，但除血压控制外，尚无临床试验报告证明这种或其他任何干预措施对女性有益。
预防计划可安全推荐反映进化常态的非药物干预措施，如改善饮食、增加运动和戒烟。预防疾病的药物干预措施需要进行临床试验。
