TERAPIA HORMONAL SUSTITUTIVA EN CLIMATERIO Y MENOPAUSIA Y RIESGO CARDIOVASCULAR: UNA REVISIÓN SISTEMÁTICA
DOI:
https://doi.org/10.47820/recima21.v3i10.1949Palabras clave:
Terapia Hormonal Substitutiva Combinada, Climaterio, Menopausa, Estrógenos, Riesgo CardiovascularResumen
Objetivo: Comprobar en la literatura científica la implicación de la terapia hormonal sustitutiva (THS) en el desarrollo de enfermedades cardiovasculares en mujeres menopáusicas. Métodos: Se realizó una revisión integradora, utilizando como criterio la búsqueda en las bases de datos científicas PubMed, Scielo y MEDLINE con el fin de buscar trabajos publicados en formato de artículo científico original, publicados entre los años 2015 y 2021. Resultados: Se observó que el inicio de la terapia hormonal sustitutiva, cuando se hace cerca de la menopausia, tiende a tener menores riesgos para la salud cardiovascular en comparación con los inicios tardíos del periodo. En consonancia con lo anterior, otras tesis corroboran la idea de que, cuando se priva al organismo, los estrógenos tienden a dañar la fisiología de la pared vascular, lo que da lugar a la mortalidad cardiovascular en el período posmenopáusico. Por otro lado, además de la hormona ovárica, es necesario evaluar otros factores que rodean el proceso de morbilidad de la menopausia, como el tabaquismo, la obesidad y el sedentarismo. Consideraciones finales: Existen beneficios cardioprotectores de la terapia hormonal sustitutiva (THS) en función del periodo de vida de las mujeres.
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Connections, v. 11, n. 4, 1 abr. 2022.
ANAGNOSTIS, P. et al. The effect of hormone replacement therapy and tibolone on lipoprotein (a) concentrations in postmenopausal women: A systematic review and meta-analysis. Maturitas, v. 99, p. 27–36, maio 2017.
BENKHADRA, K. et al. Menopausal Hormone Therapy and Mortality: A Systematic Review and Meta-Analysis. The Journal of Clinical Endocrinology and Metabolism, v. 100, n. 11, p. 4021–4028, 1 nov. 2015.
CARBONEL, A. A. F. et al. Cardiovascular system and estrogen in menopause. Revista da Associação Médica Brasileira, v. 66, p. 97–98, 15 maio 2020.
CHESTER, R. C.; KLING, J. M.; MANSON, J. E. What the Women’s Health Initiative has taught us about menopausal hormone therapy. Clinical Cardiology, v. 41, n. 2, p. 247–252, fev. 2018.
FERREIRA-CAMPOS, L. et al. Terapia Hormonal e Hipertensão em Mulheres na Pós-Menopausa: Resultados do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Arq. Bras. Cardiol., v. 118, n. 5, p. 905–913, 5 maio 2022.
HAMODA, H. et al. The British Menopause Society & Women’s Health Concern 2020 recommendations on hormone replacement therapy in menopausal women. Post Reproductive Health, p. 205336912095751, 12 out. 2020.
HIPOLITO RODRIGUES, M. A.; GOMPEL, A. Micronized progesterone, progestins, and menopause hormone therapy. Women & Health, v. 61, n. 1, p. 3–14, 21 set. 2020.
HONIGBERG, M. C. et al. Association of Premature Natural and Surgical Menopause With Incident Cardiovascular Disease. JAMA, v. 322, n. 24, p. 2411–2421, 24 dez. 2019.
JIANG, Y.; TIAN, W. The effects of progesterones on blood lipids in hormone replacement therapy. Lipids in Health and Disease, v. 16, n. 1, 21 nov. 2017.
KIM, J.-E. et al. A systematic review and meta-analysis of effects of menopausal hormone therapy on cardiovascular diseases. Scientific Reports, v. 10, n. 1, 26 nov. 2020.
LI, Y. et al. Combined effect of menopause and cardiovascular risk factors on death and cardiovascular disease: a cohort study. BMC Cardiovascular Disorders, v. 21, 23 fev. 2021.
MARTINS, M. V. F. et al. Uso de Terapia de Reposição Hormonal para Prevenção de Doenças Cardiovasculares na Pós-menopausa: Uma Revisão Sistemática / Use of Hormone Replacement Therapy to Prevent Postmenopausal Cardiovascular Diseases: A Systematic Review. Brazilian Journal of Development, v. 7, n. 6, p. 64276–64289, 29 jun. 2021.
NEWSON, L. Menopause and cardiovascular disease. Post Reproductive Health, v. 24, n. 1, p. 44–49, 17 jan. 2018.
OLIVER-WILLIAMS, C. et al. The route of administration, timing, duration and dose of postmenopausal hormone therapy and cardiovascular outcomes in women: a systematic review. Human Reproduction Update, v. 25, n. 2, p. 257–271, 1 dez. 2018.
OTTO, C. M. Heartbeat: is postmenopausal hormone therapy a risk factor or preventative therapy for cardiovascular disease in women? Heart, v. 107, n. 14, p. 1103–1105, 25 jun. 2021.
Superando a Montanha-Russa Hormonal ao Longo da Vida das Mulheres: Um Ponto de Virada para a Prevenção Cardiovascular. Disponível em: <https://abccardiol.org/short-editorial/superando-a-montanha-russa-hormonal-ao-longo-da-vida-das-mulheres-um-ponto-de-virada-para-a-prevencao-cardiovascular/>. Acesso em: 7 set. 2022.
WILD, R. A. et al. Cardiovascular disease (CVD) risk scores, age, or years since menopause to predict cardiovascular disease in the Women’s Health Initiative. Menopause, v. 28, n. 6, p. 610–618, 3 maio 2021.
ZHANG, G.-Q. et al. Menopausal hormone therapy and women’s health: An umbrella review. PLOS Medicine, v. 18, n. 8, p. e1003731, 2 ago. 2021.
ZHAO, D. et al. Endogenous Sex Hormones and Incident Cardiovascular Disease in Post-Menopausal Women. Journal of the American College of Cardiology, v. 71, n. 22, p. 2555–2566, jun. 2018.
ZHU, D. et al. Premenopausal cardiovascular disease and age at natural menopause: a pooled analysis of over 170,000 women. European Journal of Epidemiology, v. 34, n. 3, p. 235–246, 5 fev. 2019.
DAAN, N.M.P.; FAUSER, B.C.J.M. Menopause prediction and potential implications. Maturitas, v. 82, n. 3, p. 257-65, nov. 2015
HARLOW, S.D. Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. Journal Of Clinical Endocrinology & Metabolism, v. 97, n. 4, p. 1159-68, abr. 2012.
MENDELSOHN, M.E.; KARAS, R.H. The Protective Effects of Estrogen on the Cardiovascular System. New England Journal Of Medicine, v. 340, n. 23, p. 1801-11, 10 jun. 1999.
ZHAO, Z. et al. Role of estrogen in diastolic dysfunction. American Journal Of Physiology-Heart And Circulatory Physiology, v. 306, n. 5, p. 628-40, 1 mar. 2014.
ANAGNOSTIS, P. et al. Effects of menopause, gender and age on lipids and high-density lipoprotein cholesterol subfractions. Maturitas, v. 81, n. 1, p. 62-8, maio 2015
ANAGNOSTIS, P. et al. Menopausal Hormone Therapy and Cardiovascular Risk: where are we now?. Current Vascular Pharmacology, v. 17, n. 6, p. 564-72, 2 out. 2019.
MAUVAIS-JARVIS, F. et al. Menopausal Hormone Therapy and Type 2 Diabetes Prevention: evidence, mechanisms, and clinical implications. Endocrine Reviews, v. 38, n. 3, p. 173-88, 8 mar. 2017.
ABILDGAARD, J. et al. Changes in abdominal subcutaneous adipose tissue phenotype following menopause is associated with increased visceral fat mass. Scientific Reports, v. 11, n. 1, p. 14750, 20 jul. 2021.
PRICE, T.M. et al. Estrogen regulation of adipose tissue lipoprotein lipase—Possible mechanism of body fat distribution. American Journal Of Obstetrics And Gynecology, v. 178, n. 1, p. 101-7, jan. 1998.
FERRARA, C.M. et al. Differences in Adipose Tissue Metabolism between Postmenopausal and Perimenopausal Women. The Journal Of Clinical Endocrinology & Metabolism, v. 87, n. 9, p. 4166-70, 1 set. 2002.
WALTON, C. et al. The effects of the menopause on insulin sensitivity, secretion and elimination in non-obese, healthy women. European Journal Of Clinical Investigation, v. 23, n. 8, p. 466-73, ago. 1993.
ROBEVA, R. et al. The interplay between metabolic dysregulations and non-alcoholic fatty liver disease in women after menopause. Maturitas, v. 151, p. 22-30, set. 2021.
RECKELHOFF, J.F.; FORTEPIANI, L.A. Novel Mechanisms Responsible for Postmenopausal Hypertension. Hypertension, v. 43, n. 5, p. 918-23, maio 2004.
MACIEL E. L. S. da R. et al. Efeito do estrogênio no risco cardiovascular: uma revisão integrativa. Revista Eletrônica Acervo Médico, v. 1, n. 1, p. e8527, 31 ago. 2021.
STÖRK, S. et al. Estrogen, inflammation and cardiovascular risk in women: a critical appraisal. Trends In Endocrinology & Metabolism, v. 15, n. 2, p. 66-72, mar. 2004.
ROSSOUW, J.E. et al. Postmenopausal Hormone Therapy and Risk of Cardiovascular Disease by Age and Years Since Menopause. JAMA, v. 297, n. 13, p. 1465–77. 2007.
DAVIDSON, M.H. et al. Effects of Continuous Estrogen and Estrogen-Progestin Replacement Regimens on Cardiovascular Risk Markers in Postmenopausal Women. ARCH INTERN MED, v. 160, n. 21, p. 3315-25. 2000.
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