Monday, May 22, 2017

Timing of Menopause May Affect Heart Failure Risk

Women who entered menopause early or who never gave birth might have an increased risk of heart failure, a new study suggests.

Researchers analyzed data from more than 28,000 postmenopausal women who did not have heart disease at the start of the study. During an average follow-up of about 13 years, just over 5% of the women were hospitalized for heart failure.
The study was published May 15 in the Journal of the American College of Cardiology.

“Our finding that a shorter total reproductive duration was associated with a modestly increased risk of heart failure might be due to the increased coronary heart disease risk that accompanies early menopause,” senior author Dr. Nisha Parikh said in a journal news release. Parikh is an assistant professor at the University of California, San Francisco School of Medicine.

“These findings warrant ongoing evaluation of the potential cardioprotective mechanisms of sex hormone exposure in women,” Parikh added.

Previous studies found that sex hormones present during a woman’s childbearing years may affect heart disease risk.

My Take:
Last fall I attended a seminar on “Hormones & Cardiometabolic Function” presented by Jack Monaco, MD. He cited extensive research that indicates that sex hormones serve as cardioprotective.

The sex hormones appear to reduce vascular inflammation in the intima of the vessel walls. This is how atherosclerosis begins. It is only after the intima becomes inflamed that LDL cholesterol binds to homocysteine and plaque forms against the inflamed intima.

This research has created a boon for hormone replacement therapy (HRT). However, the introduction of exogenous sex hormones has significant side effects. Even bioidentical hormones down regulate cell hormone receptor sites after just two months of treatment. This requires more and more hormone to obtain the same response.

The Bottom Line:
Despite the cardiovascular protection afforded by endogenous hormones, exogenous hormone therapy has severe side effects and should be limited to short term therapy up to two months. The key is to stimulate endogenous hormone production from the adrenal glands in menopause and andropause. More on this topic in my next blog.

Source: May 15, 2017 National Institutes of Health

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