Age, menopause and hormone replacement therapy influences on cardiovascular risk factors in a cohort of middle-aged Chilean women

Castelo-Branco, Camil; Blümel, Juan E.; Roncagliolo, Manuel; Haya, Javier; Bolf, D.; Binfa, Lorena; Tacla, X; Colodrón, Marta

doi:10.1016/s0378-5122(03)00140-3

Cited by 32 publications

(15 citation statements)

References 26 publications

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“…Dyslipidemia, which may be associated with obesity, hypertension and diabetes 8,9 , was detected in 90% of our study participants. The prevalence of dyslipidemia in middle-aged women without breast cancer was shown to be 71.5% in Chile 3 and 63.4% in Iran 4 . The most common lipid disorders were high TC, LDL-C and non-HDL-C concentrations.…”

Section: Discussionmentioning

confidence: 99%

“…Dyslipidemia, obesity, age, smoking, sedentary lifestyle, hypertension and diabetes mellitus are known risk factors for CVD 1 . Previous studies have identified the high prevalence of CVD risk factors in middle-aged women 3,4 . Elevated serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were described in perimenopausal women 5,6 .…”

Section: Introductionmentioning

confidence: 99%

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Cardiovascular risk in middle-aged breast cancer survivors: a comparison between two risk models

Sousa-e-Silva¹,

Conde²,

Martinez³

et al. 2014

Rev. Bras. Ginecol. Obstet.

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PURPOSE: It was to assess the risk of cardiovascular disease (CVD) in breast cancer survivors (BCS). METHODS:This cross-sectional study analyzed 67 BCS, aged 45-65 years, who underwent complete oncological treatment, but had not received hormone therapy, tamoxifen or aromatase inhibitors during the previous 6 months. Lipid profile and CVD risk were evaluated, the latter using the Framingham and Systematic COronary Risk Evaluation (SCORE) models. The agreement between cardiovascular risk models was analyzed by calculating a kappa coefficient and its 95% confidence interval (CI). RESULTS: Mean subject age was 53.2±6.0 years, with rates of obesity, hypertension, and dyslipidemia of 25, 34 and 90%, respectively. The most frequent lipid abnormalities were high total cholesterol (70%), high LDL-C (51%) and high non-HDL-C (48%) concentrations. Based on the Framingham score, 22% of the participants had a high risk for coronary artery disease. According to the SCORE model, 100 and 93% of the participants were at low risk for fatal CVD in populations at low and high risk, respectively, for CVD. The agreement between the Framingham and SCORE risk models was poor (kappa: 0.1; 95%CI 0.01-0.2) for populations at high risk for CVD. CONCLUSIONS: These findings indicate the need to include lipid profile and CVD risk assessment in the follow-up of BCS, focusing on adequate control of serum lipid concentrations. ResumoOBJETIVO: Avaliar o risco de doença cardiovascular (DCV) em mulheres com câncer de mama. MÉTODOS: Foi conduzido estudo de corte transversal, com 67 mulheres com câncer de mama, entre 45 e 65 anos, tratamento oncológico completo, não usuárias de terapia hormonal, tamoxifeno ou inibidores da aromatase nos últimos 6 meses. Foram avaliados o perfil lipídico e o risco de DCV. Para avaliar o risco de DCV, foram utilizados os modelos Framingham e Systematic COronary Risk Evaluation (SCORE). Para investigar a concordância entre os modelos de risco cardiovascular, foi calculado o coeficiente kappa com seu respectivo intervalo de confiança (IC) de 95%. RESULTADOS: A média de idade das participantes foi de 53,2±6,0 anos. A prevalência de obesidade, hipertensão e dislipidemia foi 25, 34 e 90%, respectivamente. A prevalência de dislipidemia foi 90%. As anormalidades mais comuns do perfil lipídico foram: alto colesterol total (70%), alto LDL-C (51%) e alto não HDL-C (48%). Baseado no escore de Framingham, 22% das mulheres com câncer de mama apresentaram alto risco de doença arterial coronariana. De acordo com o modelo SCORE, 100 e 93% das participantes apresentaram baixo risco de DCV fatal, considerando populações de baixo e alto risco de DCV, respectivamente. A concordância entre os modelos de Framingham e SCORE foi ruim (kappa: 0,1; IC95% 0,01-0,2), considerando populações de alto risco de DCV. CONCLUSÕES: Esses dados indicam a necessidade de incluir a avaliação do perfil lipídico e do risco de DCV na rotina de seguimento de mulheres com câncer de mama, sendo observadoo adequado controle dos níveis séricos de lipídios.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cardiovascular risk in middle-aged breast cancer survivors: a comparison between two risk models

Sousa-e-Silva¹,

Conde²,

Martinez³

et al. 2014

Rev. Bras. Ginecol. Obstet.

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“…Sedentarism, defined as expending less than 10% of the daily energy intake in the performance of moderate-and high-intensity activities 52 , is highly prevalent in middle-aged women 53 . Physical inactivity is a well-recognized contributory factor and increase in body mass index is an additive risk factor for CHD, especially in women.…”

Section: Physical Inactivitymentioning

confidence: 99%

Management of cardiovascular risk in the perimenopausal women: a consensus statement of European cardiologists and gynecologists

Collins

Rosano²,

Casey

et al. 2007

Climacteric

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Cardiovascular risk is poorly managed in women, especially during the menopausal transition when susceptibility to cardiovascular events increases. Clear gender differences exist in the epidemiology, symptoms, diagnosis, progression, prognosis and management of cardiovascular risk. Key risk factors that need to be controlled in the perimenopausal woman are hypertension, dyslipidemia, obesity and other components of the metabolic syndrome, with the avoidance and careful control of diabetes. Hypertension is a particularly powerful risk factor and lowering of blood pressure is pivotal. Hormone replacement therapy is acknowledged as the gold standard for the alleviation of the distressing vasomotor symptoms of the menopause, but the findings of the Women's Health Initiative (WHI) study generated concern for the detrimental effect on cardiovascular events. Thus, hormone replacement therapy cannot be recommended for the prevention of cardiovascular disease. Whether the findings of WHI in older postmenopausal women can be applied to younger perimenopausal women is unknown. It is increasingly recognized that hormone therapy is inappropriate for older postmenopausal women no longer displaying menopausal symptoms. Both gynecologists and cardiovascular physicians have an important role to play in identifying perimenopausal women at risk of cardiovascular morbidity and mortality, and should work as a team to identify and manage risk factors, such as hypertension.

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“…[1][2][3][4] The risk of CHD (fatal or nonfatal) in patients with heterozygous familial hypercholesterolemia (hFH) is different between men and women. By the age of 60 years, the risk is reported to be 85% in men and 56% in women.…”

Section: Introductionmentioning

confidence: 99%

The Influence of Natural Menopause on Postprandial Lipemia in Heterozygotes for Familial Hypercholesterolemia

Kolovou

Anagnostopoulou

Pilatis

et al. 2004

Journal of Women's Health

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Age, menopause and hormone replacement therapy influences on cardiovascular risk factors in a cohort of middle-aged Chilean women

Cited by 32 publications

References 26 publications

Cardiovascular risk in middle-aged breast cancer survivors: a comparison between two risk models

Cardiovascular risk in middle-aged breast cancer survivors: a comparison between two risk models

Management of cardiovascular risk in the perimenopausal women: a consensus statement of European cardiologists and gynecologists

The Influence of Natural Menopause on Postprandial Lipemia in Heterozygotes for Familial Hypercholesterolemia

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