Менопаузальный переход — фокус на раннее и эффективное снижение кардиометаболических рисков
https://doi.org/10.31550/1727-2378-2023-22-5-40-48
Аннотация
Цель обзора: рассмотреть особенности факторов риска и частоту встречаемости сердечно-сосудистых заболеваний у женщин среднего зрелого возраста с фокусированием на период менопаузального перехода, который имеет ключевое значение для проведения ранней профилактики.
Основные положения. Исследования показали четкие паттерны неблагоприятных изменений в распределении жировой ткани, липидного профиля, структурных и функциональных показателей сосудистого здоровья в течение менопаузального перехода независимо от этапа старения женщины.
Заключение. Кардиометаболическое здоровье женщин среднего возраста систематически недооценивается, период менопаузального перехода может быть критическим окном возможностей для начала ранних превентивных вмешательств на основе междисциплинарного подхода и назначения менопаузальной гормональной терапии.
Ключевые слова
здоровое старение,
менопауза,
менопаузальный переход,
сердечно-сосудистые риски,
превентивные стратегии,
менопаузальная гормональная терапия
При поддержке: Авторы заявляют об отсутствии внешнего финансирования при проведении исследования и написании статьи
Об авторах
С. В. Юренева
ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова» Минздрава России
Россия
Россия
Светлана Владимировна Юренева, д. м. н., профессор, заместитель директора по научной работе, профессор
Институт онкогинекологии и маммологии; кафедра акушерства и гинекологии
117997; ул. Академика Опарина, д. 4; Москва
Я. А. Орлова
ФГБОУ ВО «Московский государственный университет имени М.В. Ломоносова»
Россия
Россия
Яна Артуровна Орлова, д. м. н., профессор, заведующая отделом, заведующая кафедрой
Медицинский научно-образовательный центр; отдел возраст-ассоциированных заболеваний; факультет фундаментальной медицины; кафедра терапии
119991; Ленинские горы, д. 1; Москва
Список литературы
1. DeVito L.M., Barzilai N., Cuervo A.M. et al. Extending human healthspan and longevity : a symposium report. Ann. N. Y. Acad. Sci. 2022;1507(1):70–83. DOI: 10.1111/nyas.1468
2. Maas A.H.E.M., Rosano G., Cifkova R. et al. Cardiovascular health after menopause transition, pregnancy disorders, and other gynaecologic conditions: a consensus document from European cardiologists, gynaecologists, and endocrinologists. Eur. Heart J. 2021;42:967–984. DOI: 10.1093/eurheartj/ehaa1044
3. El Khoudary S.R., Aggarwal B., Beckie T.M. et al. Menopause transition and cardiovascular disease risk: implications for timing of early prevention: a scientific statement from the American Heart Association. Circulation. 2020(25);142:e506–e532. DOI: 10.1161/CIR.0000000000000912
4. Maas A.H.E.M. Maintaining cardiovascular health: an approach specific to women. Maturitas. 2019;124:68–71. DOI: 10.1016/j.maturitas.2019.03.021
5. Stuenkel C.A. Do we have new preventive strategies for optimizing cardiovascular health in women? Climacteric. 2019;22(2):133–139. DOI: 10.1080/13697137.2018.1561665
6. Cushman M., Shay C., Howard V. et al. Ten-year differences in women’s awareness related to coronary heart disease: results of the 2019 American Heart Association National Survey: a special report from the American Heart Association. Circulation. 2021;143(7):e239–e248. DOI: 10.1161/CIR.0000000000000907
7. Wenger N.K., Lloyd-Jones D.M., Elkind M.S.V. et al. American Heart Association. Call to action for cardiovascular disease in women: epidemiology, awareness, access, and delivery of equitable health care: a presidential advisory from the American Heart Association. Circulation 2022;145:e1059–e1071. DOI: 10.1161/CIR.0000000000001071
8. Bello N.A., Merz C.N.B., Cheng S. A scientific imperative as seen through a sharpened lens: sex, gender, and the cardiovascular condition. Circ. Res. 2022;130:433–435. DOI: 10.1161/CIRCRESAHA.122.320825
9. Luu J.M., Wei J., Shufelt C.L. et al. Clinical Practice Variations in the Management of Ischemia With No Obstructive Coronary Artery Disease. J. Am. Heart Assoc. 2022;11:e022573. DOI: 10.1161/JAHA.121.022573
10. Maas A.H.E.M., Bouatia-Naji N., Persu A., Adlam D. Spontaneous coronary artery dissections and fibromuscular dysplasia: Current insights on pathophysiology, sex and gender. Int. J. Cardiol 2019;286:220–225. DOI: 10.1016/j.ijcard.2018.11.023
11. Ibanez B., James S., Agewa S. et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur. Heart J. 2018;39(2):119–177. DOI: 10.1093/eurheartj/ehx393
12. Shaw L.J., Min J.K., Nasir K. et al. Sex differences in calcified plaque and long-term cardiovascular mortality: observations from the CAC Consortium. Eur. Heart J. 2018;39(41):3727–3735. DOI: 10.1093/eurheartj/ehy534
13. Konst R.E., Elias-Smale S.E., Lier A. et al. Different cardiovascular risk factors and psychosocial burden in symptomatic women with and without obstructive coronary artery disease. Eur. J. Prev. Cardiol 2019;26(6):657–659. DOI: 10.1177/2047487318814298
14. Parikh N.I., Gonzalez J.M., Anderson C.A.M. et al. Adverse pregnancy outcomes and cardiovascular disease risk: unique opportunities for cardiovascular disease prevention in women: a scientific statement from the American Heart Association. Circulation. 2021;143(18):e902–e916. DOI: 10.1161/CIR.0000000000000961
15. Visseren F.L.J., Mach F., Smulders Y.M. et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur. Heart J. 2021;42(34):3227–3337. DOI: 10.1093/eurheartj/ehab484
16. do Couto C.P., Policiano C., Pinto F.J. et al. Endometriosis and cardiovascular disease : A systematic review and meta-analysis. Maturitas. 2023;171:45–52. DOI: 10.1016/j.maturitas.2023.04.001
17. Zhao L., Zhu Z., Lou H. et al. Polycystic ovary syndrome (PCOS) and the risk of coronary heart disease (CHD): a meta-analysis. Oncotarget. 2016;7(23):33715–33721. DOI: 10.18632/oncotarget.9553;7:33715-21
18. Cho L., Davis M., Elgendy I. et al. Summary of updated recommendations for primary prevention of cardiovascular disease in women : JACC state-of-the-art review. J. Am. Coll. Cardiol 2020;75(20):2602–2618. DOI: 10.1016/j.jacc.2020.03.060
19. Lia M., Zhub Y., Weid J. et al. The global prevalence of premature ovarian insufficiency : a systematic review and meta-analysis. Climacteric. 2023;26(2):95–102. DOI: 10.1080/13697137.2022.2153033
20. Santoro N., Roeca C., Peters B.A., Neal-Perry G. The menopause transition: signs, symptoms, and management options. J. Clin. Endocrinol. Metab. 2021;106(1):1–15. DOI: 10.1210/clinem/dgaa764
21. Harlow S.D., Gass M., Hall J.E. et al. Executive summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive aging. Climacteric. 2012;15(2):105–114. DOI: 10.3109/13697137.2011.650656
22. El Khoudary S.R., Greendale G., Crawford S.L. et al. The menopause transition and women’s health at midlife: a progress report from the Study of Women’s Health Across the Nation (SWAN). Menopause. 2019;26(10):1213–1227. DOI: 10.1097/GME.0000000000001424
23. Bacon E.R., Mishra A., Wang Y. et al. Neuroendocrine aging precedes perimenopause and is regulated by DNA methylation. Neurobiol. Aging 2019;74:213–224. DOI: 10.1016/j.neurobiolaging.2018.09.029
24. Carson M.Y., Thurston R.C. Vasomotor symptoms and their links to cardiovascular disease risk. Curr. Opin. Endocr. Metab. Res 2023;30:100448. DOI: 10.1016/j.coemr.2023.100448
25. Thurston R.C. Symptom reporting, cardiovascular disease, and mortality as women age: it is more than menopause. Menopause. 2022;29(12):1355–1356. DOI: 10.1097/GME.0000000000002121
26. Юренева С.В., Аверкова В.Г. Вазомоторные симптомы в менопаузе: центральные триггеры, эффекторы и новые возможности патогенетической терапии. Российский вестник акушера-гинеколога 2018;5:43–48. DOI: 10.17116/rosakush20181805143
27. Nappi R.E., Siddiqui E., Todorova L. et al Prevalence and quality-of-life burden of vasomotor symptoms associated with menopause: A European cross-sectional survey Maturitas. 2023;167:66–74. doi: 10.1016/j.maturitas.2022.09.006
28. Miller V.M., Kling J.M., Files J.A. et al. What’s in a name: are menopausal ‘‘hot flashes’’ a symptom of menopause or a manifestation of neurovascular dysregulation? Menopause. 2018;25(6):700–703. DOI: 10.1097/GME.000000000000106
29. Thurston R.C., Carroll J.E., Levine M. et al. Vasomotor symptoms and accelerated epigenetic aging in the Women's Health Initiative (WHI). J. Clin. Endocrinol. Metab. 2020;105(4):1221–1227. DOI: 10.1210/clinem/dgaa081
30. Armeni A., Anagnostis P., Armeni E. et al. Vasomotor symptoms and risk of cardiovascular disease in peri- and postmenopausal women : A systematic review and meta-analysis. Maturitas. 2023;171:13–20. DOI: 10.1016/j.maturitas.2023.02.004
31. Muka T., Oliver-Williams C., Colpani V. et al. Association of vasomotor and other menopausal symptoms with risk of cardiovascular disease : a systematic review and meta-analysis. PLoS One. 2016;11:e0157417. DOI: 10.1371/journal.pone.0157417
32. Vogel B., Acevedo M., Appelman Y. et al. The Lancet women and cardiovascular disease commission: reducing the global burden by 2030. Lancet. 2021;397(10292):2385–2438. DOI: 10.1016/S0140-6736(21)00684-X
33. Newson L. Menopause and cardiovascular disease. Post. Reprod. Health. 2018;24(1):44–49. DOI: 10.1177/2053369117749675
34. Samargandy S., Matthews K.A., Brooks M.M. et al. Trajectories of blood pressure in midlife women: does menopause matter? Circ. Res. 2022;130:312–322. DOI: 10.1161/CIRCRESAHA.121.319424
35. Cifkova R., Pitha J., Krajcoviechova A., Kralikova E. Is the impact of conventional risk factors the same in men and women? Plea for a more gender-specific approach. Int. J. Cardiol. 2019;286:214–219. DOI: 10.1016/j.ijcard.2019.01.039
36. D'Ignazio T., Grand'Maison S., Bérubé L. et al. Hypertension across a woman's lifespan. Maturitas. 2023;168:84–91. doi: 10.1016/j.maturitas.2022.11.006
37. Samargandy S., Matthews K.A., Brooks M.M. et al. Arterial stiffness accelerates within 1 year of the final menstrual period: the SWAN Heart Study. Arterioscler. Thromb. Vasc. Biol. 2020;40:1001–1008. DOI: 10.1161/ATVBAHA.119.313622
38. Hildreth K.L., Ozeme C., Kohrt W.M. et al. Vascular dysfunction across the stages of the menopausal transition is associated with menopausal symptoms and quality of life. Menopause. 2018;25(9):1011–1019. DOI: 10.1097/GME.0000000000001112
39. Thurston R.C., Karvonen-Gutierrez C.A., Derby C.A. et al. Menopause versus chronologic aging: their roles in women’s health. Menopause. 2018;25:849–854. DOI: 10.1097/GME.0000000000001143
40. Ding M., Manson J.E. HDL-C and arterial calcification in midlife women: does an HDL paradox exist? Menopause. 2021;28(3):231–233. DOI: 10.1097/GME.0000000000001734
41. Kronenberg F., Mora S., Stroes E.S.G. et al. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. Eur. Heart J. 2022;43(39):3925–3946. DOI: 10.1093/eurheartj/ehac361
42. Roa-Díaz Z.M., Wehrli F., Lambrinoudaki I. et al. Early menopause and cardiovascular risk factors: a cross-sectional and longitudinal study. Menopause. 2023;30(6): 599–606. DOI: 10.1097/GME.0000000000002184
43. Kase N.G., Friedman E.G., Brodman M. et al. The midlife transition and the risk of cardiovascular disease and cancer. Part I: magnitude and mechanisms. Am. J. Obstet. Gynecol. 2020;223(6):820–833. doi: 10.1016/j.ajog.2020.05.051
44. Slopien R., Wender-Ozegowska E., Rogowicz-Frontczak A. et al. Menopause and diabetes: EMAS clinical guide. Maturitas. 2018;117:6–10. DOI: 10.1016/j.maturitas.2018.08.009
45. Woodward M., Peters S.A.E., Huxley R.R. Diabetes and the female disadvantage. Womens Health (Lond.). 2015;11(6):833–839. DOI: 10.2217/whe.15.67
46. Banack H.R., Wactawski-Wende J., Hovey K.M., Stokes A. Is BMI a valid measure of obesity in postmenopausal women? Menopause. 2018;25:307–313. DOI: 10.1097/GME.0000000000000989
47. Wong J.C.H., O’Neill S., Beck B.R. et al. A 5-year longitudinal study of changes in body composition in women in the perimenopause and beyond. Maturitas. 2020;132:49–56. DOI: 10.1016/j.maturitas.2019.12.001
48. Greendale G.A., Sternfeld B., Huang M. et al. Changes in body composition and weight during the menopause transition. JCI Insight. 2019;4:e124865. DOI: 10.1172/jci.insight.124865
49. Ueda Y., Shiga Y., Idemoto Y. et al. Association between the presence or severity of coronary artery disease and pericardial fat, paracardial fat, epicardial fat, visceral fat, and subcutaneous fat as assessed by multi-detector row computed tomography. Int. Heart J. 2018;59(4):695–704. DOI: 10.1536/ihj.17-234
50. Laine C., Wee C.C. Overweight and obesity: current clinical challenges. Ann. Intern. Med. 2023;176(5):699–700. DOI: 10.7326/M23-0628
51. Ross R., Neeland I.J., Yamashita S. et al. Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity. Nat. Rev. Endocrinol. 2020;16:177–189. DOI: 10.1038/s41574-019-0310-7
52. Юренева С.В., Комедина В.И., Кузнецов С.Ю. Диагностические возможности антропометрических показателей для оценки ожирения у женщин в период менопаузального перехода. Акушерство и гинекология. 2022;(2):72–79. DOI: 10.18565/aig.2022.2.72-79
53. Mosca L, Benjamin EJ, Berra K, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women — 2011 update: a guideline from the American Heart Association. Circulation 2011;123: 1243–1262. DOI: 10.1161/CIR.0b013e31820faaf8
54. Lloyd-Jones D.M., Allen N.B., Anderson C.A.M. et al. Life’s Essential 8: Updating and Enhancing the American Heart Association’s Construct of Cardiovascular Health: A Presidential Advisory from the American Heart Association. Circulation. 2022;146(5):18–43. DOI: 10.1161/CIR.0000000000001078
55. Zhou T., Yuan Y., Xue Q. et al. Adherence to a healthy sleep pattern is associated with lower risks of all-cause, cardiovascular and cancer-specific mortality. J. Intern. Med. 2021;291(1):64–71. DOI: 10.1111/joim.13367
56. Grundy S.M., Stone N.J., Bailey A.L. et al. 2018 guideline on the management of blood cholesterol: a report of the American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139:e1182–1186]. Circulation 2019;139:e1082–e1143. DOI: 10.1161/CIR.0000000000000625
57. DePree B., Houghton K., Shiozawa A. et al. Treatment and resource utilization for menopausal symptoms in the United States : a retrospective review of real-world evidence from US electronic health records. Menopause. 2023;30(1):70–79. DOI: 10.1097/GME.0000000000002095
58. Cho L., Kaunitz A.M., Faubion S.S. et al. Rethinking Menopausal Hormone Therapy: For Whom, What, When, and How Long? Circulation. 2023;147:597–610. DOI: 10.1161/CIRCULATIONAHA.122.061559
59. Mehta J., Kling J.M., Manson J.E. Risks, benefits, and treatment modalities of menopausal hormone therapy: current concepts. Front. Endocrinol. (Lausanne) 2021:12:564781. DOI: 10.3389/fendo.2021.564781
60. Manson J.E., Aragaki A.K., Rossouw J.E. et al. Menopausal hormone therapy and long-term all-cause and cause-specific mortality: the Women’s Health Initiative randomized trials. JAMA. 2017;318:927–938. DOI: 10.1001/jama.2017.11217
61. Miller V.M., Naftolin F., Asthana S. et al. The Kronos Early Estrogen Prevention Study (KEEPS): what have we learned? Menopause. 2019;26(9):1071–1084. DOI: 10.1097/GME.0000000000001326
62. Hodis H.N., Mack W.J., Henderson V.W. et al; ELITE Research Group. Vascular effects of early versus late postmenopausal treatment with estradiol. N. Engl. J. Med. 2016;374(13):1221–1231. DOI: 10.1056/NEJMoa1505241
63. El Khoudary S.R., Zhao Q., Venugopal V. et al. Effects of hormone therapy on heart fat and coronary artery calcification progression: secondary analysis from the KEEPS trial. J. Am. Heart Assoc. 2019;8:e012763. DOI: 10.1161/JAHA.119.012763115
64. Faubion S.S., Crandall C.J., Davis L. et al. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022;29(7):767–794. DOI: 10.1097/GME.0000000000002028
65. El Khoudary S.R., Venugopal V., Manson J.E. et al. Heart fat and carotid artery atherosclerosis progression in recently menopausal women: impact of menopausal hormone therapy: the KEEPS trial. Menopause. 2020;27:255–262. DOI: 10.1097/GME.0000000000001472
66. Gambacciani M., Cagnacci A., Lello S. Hormone replacement therapy and prevention of chronic conditions. Climacteric. 2019;22(3):303–306. DOI: 10.1080/13697137.2018.1551347
67. Dinger J., Bardenheuer K., Heinemann K. Drospirenone plus estradiol and the risk of serious cardiovascular events in postmenopausal women. Climacteric. 2016;19(4):349–356. DOI: 10.1080/13697137.2016.1183624
Рецензия
Для цитирования:
Юренева С.В., Орлова Я.А. Менопаузальный переход — фокус на раннее и эффективное снижение кардиометаболических рисков. Доктор.Ру. 2023;22(5):40-48. https://doi.org/10.31550/1727-2378-2023-22-5-40-48
For citation:
Yureneva S.V., Orlova Ya.A. Menopausal Transition — Time for Early and Effective Targeting of Cardiometabolic Risks. Title. 2023;22(5):40-48. (In Russ.) https://doi.org/10.31550/1727-2378-2023-22-5-40-48
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