JAMA:40岁前绝经导致中年女性心血管风险增加

2019-12-23 MedSci MedSci原创

研究发现,40岁以前绝经人群的心血管疾病的风险小幅增加,特别是因双侧卵巢切除导致的手术绝经人群

最近的指南建议40岁以前绝经的中年妇女进行动脉粥样硬化性心血管疾病的风险评估。近日研究人员探讨40岁前自然绝经和手术绝经妇女心血管疾病的发展及心血管危险因素。

40至69岁绝经后妇女参与研究,分为自然过早绝经(绝经前40岁以前且没有卵巢切除术)和手术过早绝经(40岁之前接受双侧卵巢切除术)。以未过早绝经的更年期作女性为参考组。研究的主要结局为合并发生的冠状动脉疾病、心力衰竭、主动脉瓣狭窄、二尖瓣返流、心房颤动、缺血性卒中、外周动脉疾病和静脉血栓栓塞。次要结果为高血压,高脂血症和II型糖尿病

144260名绝经后妇女,平均年龄为59.9岁,4904人(3.4%)为自然过早绝经,644人(0.4%)为手术过早绝经,平均随访7年。无过早绝经5415名妇女发生终点事件(3.9%,发病率,5.70/1000妇女-年),自然过早绝经组292例发生主要终点事件(发病率,8.78/1000妇女-年,差异3.08/1000妇女-年),手术过早绝经组49名妇女发生主要终点事件(发病率,11.27/1000妇女-年,差异+5.57/1000妇女-年)。相对于未过早绝经,自然绝经和手术绝经组主要终点的危险比分别为1.36和1.87。

研究发现,40岁以前绝经人群的心血管疾病的风险小幅增加,特别是因双侧卵巢切除导致的手术绝经人群。

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    2019-12-23 旺医

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