Role of Menopausal Hormone Therapy for Prevention of Cardiovascular Disorders and Maintenance of Cognitive Function: A Literature Review
No Thumbnail Available
Date
2021
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Menopauzes hormonu terapija (MHT) iepriekš tika plaši izmantota dažādu medicīnisko stāvokļu novēršanai, kuri bija saistīti ar endogēno estrogēnu līmeņa samazināšanos menopauzes dēļ. Šī klīniskā prakse ievērojami mainījās pēc Women’s Health Initiative (WHI) pētījuma rezultātu publiskošanas, kuri liecināja, ka MHT ir negatīva ietekme uz kardiovaskulāro un krūts vēža risku, kā arī kognitīvo funkciju. Jaunākie pētījumi liecina, ka WHI bija ievērojami ierobežojumi un šobrīd ir pierādīti labvēlīgi MHT efekti uz sirds un asinsvadu sistēmu, kā arī kognitīvo funkciju. Tomēr par spīti šiem atklājumiem vadlīnijas vēl joprojām ievērojami ierobežo MHT lietošanu un nerekomendē MHT primārai un sekundārai kardiovaskulāro slimību novēršanai, kā arī kognitīvo funkciju uzturēšanai.
Šis pētījums ir tematisks literatūras apskats, kas balstīts galvenokārt uz jaunākajiem recenzētajiem primārajiem zinātniskās literatūras avotiem, kā arī nozīmīgākajiem pētījumiem par menopauzes hormonu terapiju. Pētījuma mērķis ir pārskatīt, apkopot un analizēt kvalitatīvu zinātnisko informāciju par ieguvumiem un riskiem, kas saistīti ar menopauzes hormonu terapijas lietošanu primārai un sekundārai kardiovaskulāro slimību novēršanai un kognitīvo funkciju uzturēšanai.
Galvenie pētījuma secinājumi – lai gan zinātniskās literatūras dati par MHT lomu kognitīvo funkciju uzturēšanā nav viennozīmīgi, pastāv nozīmīgu pierādījumu kopums, kas liecina par MHT drošumu un efektivitāti kardiovaskulāro slimību novēršanā, ja terapija uzsākta agrīnā menopauzē sievietēm bez sirds un asinsvadu slimībām; tādēļ primāra kardiovaskulāro slimību profilakse būtu jāapsver kā atsevišķa indikācija MHT lietošanai.
In the past menopausal hormone therapy (MHT) was widely used for the prevention of different health issues related to endogenous estrogen decline caused by menopause. This practice was changed dramatically after the results of Women’s Health Initiative (WHI) study emerged demonstrating the harmful effects of MHT on the cardiovascular health, breast cancer risk profile and cognition. More recent research data has, however, shown that the WHI study had its flaws and new evidence is available demonstrating the beneficial effects of MHT on the cardiovascular and cognitive risks and outcomes. Despite these findings guidelines on MHT indications have remained largely restrictive and the use of MHT is not recommended for primary or secondary prevention of cardiovascular disorders and cognitive decline. Research paper is a thematic literature review – mainly based on current peer-reviewed primary literature sources and landmark studies – with the aim to review, compile and analyse quality scientific data on the risks and benefits of MHT for primary and secondary prevention of cardiovascular disease and cognitive decline. The main conclusion of the research paper is that while data on the effect of MHT on the maintenance of cognitive function is inconclusive, there is a considerable body of evidence on the safety and efficacy of MHT for the prevention of cardiovascular disorders when initiated early in the menopause and in healthy women; therefore, primary prevention of cardiovascular disease should be considered as a general indication for the use of MHT.
In the past menopausal hormone therapy (MHT) was widely used for the prevention of different health issues related to endogenous estrogen decline caused by menopause. This practice was changed dramatically after the results of Women’s Health Initiative (WHI) study emerged demonstrating the harmful effects of MHT on the cardiovascular health, breast cancer risk profile and cognition. More recent research data has, however, shown that the WHI study had its flaws and new evidence is available demonstrating the beneficial effects of MHT on the cardiovascular and cognitive risks and outcomes. Despite these findings guidelines on MHT indications have remained largely restrictive and the use of MHT is not recommended for primary or secondary prevention of cardiovascular disorders and cognitive decline. Research paper is a thematic literature review – mainly based on current peer-reviewed primary literature sources and landmark studies – with the aim to review, compile and analyse quality scientific data on the risks and benefits of MHT for primary and secondary prevention of cardiovascular disease and cognitive decline. The main conclusion of the research paper is that while data on the effect of MHT on the maintenance of cognitive function is inconclusive, there is a considerable body of evidence on the safety and efficacy of MHT for the prevention of cardiovascular disorders when initiated early in the menopause and in healthy women; therefore, primary prevention of cardiovascular disease should be considered as a general indication for the use of MHT.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Menopauzes hormonu terapija, kardiovaskulāro slimību, kognitīvo funkciju, Menopausal hormone therapy, cardiovascular disorder, cognitive function, window of opportunity