Vascular Age: Key Predictor of Heart Disease Risk With Hormone Therapy

The decisions about hormone therapy can depend on a woman’s cardiovascular disease risk, or vascular age, according to a recent study published in the journal Menopause.

Hormone therapy can increase the risk of cardiovascular disease because of the aging process and an increase in other risk factors like high blood pressure and obesity during midlife.

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‘Measuring a woman’s cardiovascular disease risk, or vascular age, is a better tool for deciding hormone therapy.’

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So, determining a woman’s vascular age is a better indicator for hormonal therapy than her chronological age or years since menopause.

Physicians generally considered a woman’s age and menopause period duration for hormone therapy risk is unclear as other risk factors are ignored. So, researchers decided to look for the true risk of cardiovascular disease independent of age.

“Age certainly plays a role, but it is modified by other risk factors. We have to make individualized decisions instead of using a broad-brush stroke”, said Wild, the lead author of the study.

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Researchers studied data from the Women’s Health Initiative, a long-term research project that focused on strategies for preventing heart disease and several other conditions in post-menopausal women.

This trial included 27,347 post-menopausal women aged from 50 to 79 between 1993 to 1998 across the United States; some received hormone therapy and some received a placebo.

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The trial continued to analyze them for nearly 18 years so there was vast information about which women ended up with cardiovascular disease.

To examine that data, they used two different cardiovascular risk scoring systems. One is from the American Heart Association and American College of Cardiology, and the other is called the Framingham Risk Score.

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The two scoring systems are similar in assessing vital signs like age, race, total cholesterol, HDL (the “good” part of cholesterol), systolic blood pressure, use of blood pressure medication, diabetes and smoking status. The Framingham score differs because it substitutes body mass index (BMI) for HDL cholesterol.

The results show that both cardiovascular risk scoring systems were a better predictor of cardiovascular disease than chronological age and years since menopause.

Hormone therapy has led to polarization among medical fields as cardiologists tend to be against hormone therapy, while gynaecologists and primary care physicians more likely to prescribe it to ease their patients’ symptoms.

However, this study provides a middle ground and an enhanced method of predicting cardiovascular risk among menopausal women. They also hope that this approach can become part of clinical practice because these risk scoring systems are easy to use and many health systems have integrated them into their electronic health records.

Source-Medindia