Journal Article

Vascular Effects of Early versus Late Postmenopausal Treatment with Estradiol

Dustin, Laurie, Selzer, Robert H, Stanczyk, Frank Z, Hwang-Levine, Juliana, Kono, Naoko, Henderson, Victor W, Shoupe, Donna, Li, Yanjie, Hodis, Howard N, Mack, Wendy J, Budoff, Matthew J, Azen, Stanley P, Feng, Mei

2016

نظرة عامة

In this trial, which was stratified by time since menopause (<6 or ≥10 years), 17β-estradiol treatment was associated with less progression of atherosclerosis than was placebo when therapy was initiated early after menopause but not when initiated late after menopause. After dozens of observational studies consistently showed inverse associations between postmenopausal hormone therapy and the risk of coronary heart disease and death from any cause, it was difficult to understand the null or adverse effects of the therapy on coronary heart disease that were reported from randomized, controlled trials. One explanation is that in observational studies, women were younger (approximately 50 years of age) and closer to menopause (typically within 2 years) when they initiated hormone therapy than were the women included in randomized trials (mean age in the 60s, typically >10 years past menopause). This so-called timing hypothesis posits . . .

• الناشر: Massachusetts Medical Society
• موضوع: 17β-Estradiol / Administration, Intravaginal / Administration, Oral / Aging / Arteriosclerosis / Atherosclerosis / Atherosclerosis - prevention & control / Calcium / Cardiovascular diseases / Carotid Arteries - drug effects / Carotid Arteries - pathology / Carotid artery / Carotid Intima-Media Thickness / Clinical outcomes / Computed tomography / Coronary artery / Coronary Artery Disease - prevention & control / Disease Progression / Dosage and administration / Drug Administration Schedule / Estradiol / Estradiol - administration & dosage / Estrogen / Estrogen Replacement Therapy / Estrogens / Female / Health aspects / Heart / Hormone replacement therapy / Humans / Linear Models / Menopause / Middle Aged / Post-menopause / Postmenopausal women / Postmenopause - drug effects / Progesterone / Progesterone - administration & dosage / Risk factors / Stenosis / Uterus / Vagina / Womens health