文档介绍：Estrogen Replacement Therapy and the Prevention of Coronary Heart Disease in Women:
Friend or Foe?
David Parra, ., BCPS
Clinical Pharmacy Specialist
Department of Cardiology
Veterans Affairs Medical Center
West Palm Beach, FL
Objectives
Understand the magnitude of coronary heart disease (CHD) in postmenopausal women
Explain the mechanisms behind estrogen’s proposed cardioprotective effect
Review the observational data supporting the use of estrogen in preventing CHD
Discuss the results of the pleted Heart and Estrogen/progestin Replacement Study (HERS) and apply them to clinical practice
Cardiovascular Disease in Women
One in two women will die of cardiovascular disease (CVD)
if all forms of major CVD were eliminated life expectancy would increase by 10 years
One in 26 women will die of breast cancer
if all forms of cancer were eliminated life expectancy would increase by 3 years
1998 Heart and Stroke Statistical Update, AHA.
63% of women (48% of men) die suddenly from coronary heart disease
44% of women (27% of men) will die within one year after a heart attack
Cardiovascular Disease in Women
1998 Heart and Stroke Statistical Update, AHA.
505,440
33,130
256,844
48,961
45,136
0
100
200
300
400
500
600
Total CV
Cancer
COPD
Pneumonia
Flu
Diabetes
Deaths in thousands
Leading Causes of Death for All Females
United States 1995 Mortality Data
Adapted from 1998 Heart and Stroke Statistical Update, AHA.
50% Coronary Heart Disease
1% Congenital Heart Defects
1% Rheumatic Fever/ Rheumatic Heart Disease
4% Congestive Heart Failure
2% Atherosclerosis
4% High Blood Pressure
22% Other
Coronary Heart Disease: Despite Advances, Still the #1 Killer
Percentage Breakdown of Deaths From Cardiovascular Diseases
United States: 1995 Mortality, Final Data
16% Stroke
American Heart Association 1998 Heart and Stroke Facts: Statistical Update
420
440
460
480
500
520
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
Year