Статья
Менопаузальная гормональная терапия и сердечно-сосудистая профилактика: желаемое или действительное?
Сердечно-сосудистые заболевания являются основной причиной смерти женщин старших возрастных групп. В течение многих десятилетий проводятся попытки профилактики их развития путем применения эстрогенов. В обзоре литературы представлены современные данные о влиянии менопаузальной гормональной терапии (МГТ) на риск развития сердечно-сосудистых осложнений. Обсуждены результаты основных рандомизированных клинических и обсервационных исследований в этой области, проведенных за несколько десятилетий. Описана концепция «окна возможностей», в соответствии с которой улучшение сердечно-сосудистого прогноза можно ожидать только при начале МГТ у женщин в возрасте до 60 лет в ранней постменопаузе с давностью менопаузы <10 лет. Имеются экспериментальные и клинические данные, объясняющие различное влияние эстрогенов на сердечно-сосудистый прогноз у женщин разных возрастных групп, с разной продолжительностью постменопаузы. Приведенные в обзоре рекомендации по применению МГТ базируются на современных международных руководствах по этому вопросу.
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