Title (croatian) Kardiovaskularno zdravlje u menopauzi Title (english) Cardiovascular health in menopause Author Ivan Jandrić Author Marina Šprem Goldštajn Author Slavko Orešković Author Ivan Bolanča Author Boris Grizelj Author Mislav Mikuš Author's institution University of Zagreb Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract (croatian) Bolesti srca i krvožilnog sustava najučestaliji su uzrok smrtnosti u Europi. Prema najnovijim podatcima, čak 10% više smrtnosti od kardiovaskularnih bolesti zastupljeno je kod žena u odnosu na muškarce, što znači da u Europi zbog kardiovaskularnih razloga godišnje umire 300.000 žena više nego muškaraca. U većini istraživanja menopauza je istaknuta kao primarni čimbenik koji doprinosi povećanju kardiovaskularnog rizika u žena, usprkos metodološkim ograničenjima u obliku razdvajanja kronološkog starenja i menopauze. Proaterogene promjene u lipidogramu tijekom menopauzalne tranzicije smatraju se najsnažnijom poveznicom između nastupa menopauze i porasta kardiovaskularnog rizika. Kohortne studije nisu našle uzročnu povezanost nastupa menopauze s promjenama krvnog tlaka te homeostazom glukoze i inzulina, odnosno s rizikom razvoja šećerne bolesti. Uloga estrogena u očuvanju kardiovaskularnog zdravlja, uza sve gore opisane izravne učinke na srce i krvne žile, uključuje mehanizme kojima se regulira profil lipida, inzulinska osjetljivost te monocitno-makrofagni sustav, a čiji ispadi funkcije doprinose multifaktorijalnom procesu ateroskleroze koji u znatnoj mjeri modulira kardiovaskularni rizik. Sinteza brojnih istraživanja o molekularnim mehanizmima ističe da je estrogenska protekcija krvožilja i srca posljedica neposrednog učinka estrogena na vazodilataciju, angiogenezu, unaprjeđenje mitohondrijalne funkcije i sniženje razine oksidativnog stresa te supresiju fibroze. Promatrajući sve znanstvene spoznaje o utjecajima hormonskog nadomjesnog liječenja na profil kardiovaskularnog rizika, bitno je znati da je razvoj HNL-a bitno proširio mogućnost optimizacije i individualizacije terapije, a time su dodatno reducirani potencijalni rizici. Uz transdermalni put primjene, terapijske režime s niskim i ultraniskim dozama hormona te primjenu prirodnoga mikroniziranog progesterona i didrogesterona, kardiovaskularno zdravlje žena u menopauzi može biti značajno unaprijeđeno.
Abstract (english) Cardiovascular diseases are the most common cause of death in Europe. They are the cause of 40% of deaths in the male population and 49% of deaths in women, which means that 300,000 more women than men die of cardiovascular causes in Europe each year. Most studies have identified menopause as the major contributor to increased cardiovascular risk in women, although it has been methodologically difficult to separate chronological aging from menopause. Pro-atherogenic changes in lipidogram during transition to menopause may be considered the strongest link between the onset of menopause and the increase in cardiovascular risk. As with blood pressure changes, cohort studies have not found a causal relationship between the onset of menopause and glucose and insulin homeostasis or the risk of developing diabetes. The role of estrogen in maintaining cardiovascular health includes, in addition to all direct cardiovascular effects described above, estrogenic mechanisms
that regulate lipid profile, insulin sensitivity, and monocyte-macrophage system, the bursts of which contribute to the multifactorial process of atherosclerosis which considerably modulates cardiovascular risk. Synthesis of numerous studies on molecular mechanisms leads to the conclusion that estrogenic protection of blood vessels and the heart is due to the direct action of estrogen on vasodilation, angiogenesis, improvement of mitochondrial function and reduction of oxidative stress, and suppression of fibrosis. It is important to note that the development
of hormone replacement therapy (HRT) has greatly increased the ability to optimize and individualize therapy, further reducing potential risks. With the transdermal route of administration, low- and ultralow-dose therapeutic regimens, and the use of natural micronized progesterone and dydrogesterone, cardiovascular health in menopausal women can be significantly improved.
Keywords (croatian)
KARDIOVASKULARNE BOLESTI – epidemiologija, patofiziologija, prevencija
MENOPAUZA – fiziologija, metabolizam
ATEROSKLEROZA – patofiziologija
ESTROGENI – fiziologija, metabolizam
LIPOPROTEINI VISOKE GUSTOĆE – u krvi
VAZOMOTORIČKI SUSTAV
HORMONSKO NADOMJESNO LIJEČENJE – metode
ESTROGENSKO NADOMJESNO LIJEČENJE
RIZIČNI ČIMBENICI
Keywords (english)
CARIOVASCULAR DISEASES – epidemology, physiopathology, prevention and control
MENOPAUSE – metabolism, physiology
ATHEROSCLEROSIS – physiopathology
ESTROGENS – metabolism, physiology
LIPOPROTEINS, HDL – blood
VASOMOTOR SYSTEM
HORMONE REPLACEMENT THERAPY – methods
ESTROGEN REPLACEMENT THERAPY
RISK FACTORS
Language croatian Language english Publication type Scientific paper - Review paper Publication status Published Peer review Peer review Publication version Published version Journal title Liječnički vjesnik Numbering vol. 144, no. 11-12, pp. 392-401 p-ISSN 0024-3477 e-ISSN 1849-2177 DOI https://doi.org/10.26800/LV-144-11-12-7 URN:NBN urn:nbn:hr:105:036843 Publication 2022 Document URL https://hrcak.srce.hr/289182 Type of resource Text Access conditions Open access Terms of use Created on 2023-01-18 11:52:13
