共查询到20条相似文献,搜索用时 31 毫秒
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A high prevalence of cardiovascular risk factors is reported in postmenopausal women. The objective of this review was to determine whether the effect of the menopause on lipid profile remained after adjusting for age in middle age women. The results of 10 cross sectional studies and nine longitudinal studies added evidence of a worsening effect of the menopause on total cholesterol, LDL cholesterol and triglyceride plasmatic levels. This effect remained after adjustment for age. Menopausal estrogenic deficiency could be an explanation for those results, even if the hormonal replacement therapy effect on the lipid profile remains unclear. 相似文献
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O. Nallet O. Milleron F. Monsel B. Safar I. Ghrissi J. Sergent 《Annales de cardiologie et d'angeiologie》2009,58(5):304-309
Left heart disease is the most common cause of pulmonary hypertension. Increased left-sided filling pressure leads to passive postcapillary venous hypertension. In some patients, pulmonary vasoconstriction and vascular remodeling may lead to a further increase in pulmonary pressure. When precapillary hypertension component is associated to left heart failure, the elevation of pulmonary pressure is out of proportion with left atrial pressure: transpulmonary gradient greater than 12 mmHg (mean pulmonary pressure - mean capillary pressure) and pulmonary vascular resistance greater than three Wood units. Precapillary pulmonary hypertension is common in severe systolic heart failure. Before cardiac transplantation, increased pulmonary vascular resistance greater than 3,5 Wood units are reported in 19 to 35% of patients. In those patients vasoreactivity tests are performed with inotropic and/or systemic and/or pulmonary agents to determine the risk of right heart failure after transplantation. There is no pulmonary vascular resistance level above which transplantation is contraindicated. Cardiac assistance may be used before and after transplantation when pulmonary hypertension is severe and not reversible with conventional treatment and/or pulmonary vasodilators. The contribution of precapillary PH in diastolic heart failure is not known but can be significant and lead to disproportionate PH particularly in elderly. The precapillary component of pulmonary hypertension could be a therapeutic target for specific pulmonary vasodilators. Until now pharmacological trials has been disappointing and those medications can be dangerous because of increasing blood flow to the pulmonary capillaries with a risk of pulmonary edema when left sided pressure are still elevated. 相似文献
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E. Vautrin S. Marlière H. Bouvaist R. Guerbaai G. Barone-Rochette 《Annales de cardiologie et d'angeiologie》2016,65(6):404-410
During their lives, women go through three different phases during which sex hormones play a fundamental role in contributing to specific cardiovascular and coronary risks. To evaluate this risk, we must take into account these various phases with their associated cardiovascular risk factors, and this during three key steps: contraception, pregnancy and menopause. Arterial risk linked to estrogen combined with progestin contraception, depends on the dosage of estrogen. The main cardiovascular risk factor responsible for increasing the risk of myocardial infarction is tobacco, especially after 35 years of age, contraindicating estrogen combined with progestin contraception at the benefit of progestin. Spontaneous dissections and coronary emboli are the most common coronary lesions linked with oestroprogestative contraception. Acute myocardial infarction during pregnancy occurs mostly in the peripartum or postpartum period; and is often caused by spontaneous coronary dissection lesions. Fertility treatment is not associated with an increased risk of developing cardiovascular disease later in life. Hormone therapy during menopause does not increase coronary risk in the first 10 years after menopause and may even have a protective effect, by sustaining arterial integrity. The transdermal route is to be preferred for its metabolic effect. Hormonal treatment during menopause is nonetheless contraindicated in the case of proven coronary disease and uncontrolled cardiovascular risk factors. 相似文献
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E. Giroux 《La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne》2010
The fact that numerous risk factors are continuous raises the problem of the boundary between the normal and the pathological states. Moreover, a risk factor approach to disease deeply calls into question the relevance of these concepts. In this paper, I propose an epistemological analysis of the notion of “continuity” as it is used in the context of “risk factor epidemiology”. 相似文献