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Advisor(s)
Abstract(s)
A doença arterial coronária (DAC) encontra-se entre as causas mais prevalentes de morbi-mortalidade da atualidade, acarretando, por isso, custos económicos avultados ao nível dos cuidados de saúde.
A doença arterial coronária (DAC) é de etiologia ateromatosa com maior frequência. Os principais fatores de risco para aterosclerose são níveis de HDL baixos, colesterol total e LDL elevados, Hipertensão Arterial, Diabetes Mellitus ou Tabagismo.
Nas mulheres verifica-se que os estrogénios, do mesmo modo que produzem efeitos no aparelho reprodutor, também têm efeito noutros sistemas do organismo, como é exemplo o sistema cardiovascular.
Após a menopausa, a diminuição estrogénica condiciona alterações no perfil lipídico, bem como na parede vascular, verificando-se, por isso, um risco cardiovascular aumentado, agravado pelas comorbilidades e envelhecimento natural. Estes últimos associados a um endotélio danificado e ao desequilíbrio fatores pró-inflamatórios e antioxidantes, determina um ambiente de excelência à formação da placa aterosclerótica.
Pelo referido, a necessidade em promover a saúde cardiovascular no sexo feminino é fundamental, além da prevenção de fatores de risco e tratamento adequado e individualizado em contexto de doença estabelecida.
Todavia o potencial benéfico de administração de estrogénio na pós-menopausa, a terapia de substituição hormonal não apresenta indicação na prevenção primária ou secundária de doença arterial coronária. A prescrição de terapia de substituição hormonal permanece apenas dirigida ao alívio de sintomas vasomotores, sendo importante a avaliação individualizada rigorosa do risco/benefício para cada mulher.
A necessidade acentuada em desenvolver novas pesquisas na área cardiovascular especificamente no sexo feminino é evidente, a fim de compreender e esclarecer particularidades inerentes ao organismo da mulher, averiguando qual a abordagem preventiva e terapêutica mais eficaz.
Arterial coronary disease (ACD) is among the most prevalent morbidity and mortality causes today, carrying high economic costs in every healthcare system in the world. Its etiology is, most of the times, related to atheromatosis, and its main risk factors are: low HDL cholesterol levels, associated with high total and LDL cholesterol levels, arterial hypertension, diabetes mellitus and smoking habits. Besides its effects in women’s reproductive system, estrogen is implied in many other bodily functions, such as the regulation of the cardiovascular system. After menopause, decreased estrogen levels are responsible for changes in the lipid profile, as well as in the vascular wall of every vessel in the body. These changes, in turn, increase the risk of cardiovascular disease. Co-morbidities and natural ageing also have implications in this matter, due to their correlation with damaged endothelium and an unbalanced value of pro/anti inflammatory agents. All of these factors lead to a perfect environment to the development of atherosclerosis. So, it’s crucial to promote cardiovascular health in women, as well as to determine the its most important risk factors, and to establish an individualized approach to treatment if the disease is already diagnosed. However, the potential benefit of a prophylactic estrogen-based treatment hasn’t been proved, neither in primary, nor secondary prevention. Hormone replacement therapy only remains indicated as treatment for the relief of vasomotor symptoms, being needed, nevertheless, an individualized risk/benefit judgment for every woman. There’s a real need for new research in this matter, in order to finally understand the peculiarities of the woman organism, and to find the right preventive and therapeutic approach.
Arterial coronary disease (ACD) is among the most prevalent morbidity and mortality causes today, carrying high economic costs in every healthcare system in the world. Its etiology is, most of the times, related to atheromatosis, and its main risk factors are: low HDL cholesterol levels, associated with high total and LDL cholesterol levels, arterial hypertension, diabetes mellitus and smoking habits. Besides its effects in women’s reproductive system, estrogen is implied in many other bodily functions, such as the regulation of the cardiovascular system. After menopause, decreased estrogen levels are responsible for changes in the lipid profile, as well as in the vascular wall of every vessel in the body. These changes, in turn, increase the risk of cardiovascular disease. Co-morbidities and natural ageing also have implications in this matter, due to their correlation with damaged endothelium and an unbalanced value of pro/anti inflammatory agents. All of these factors lead to a perfect environment to the development of atherosclerosis. So, it’s crucial to promote cardiovascular health in women, as well as to determine the its most important risk factors, and to establish an individualized approach to treatment if the disease is already diagnosed. However, the potential benefit of a prophylactic estrogen-based treatment hasn’t been proved, neither in primary, nor secondary prevention. Hormone replacement therapy only remains indicated as treatment for the relief of vasomotor symptoms, being needed, nevertheless, an individualized risk/benefit judgment for every woman. There’s a real need for new research in this matter, in order to finally understand the peculiarities of the woman organism, and to find the right preventive and therapeutic approach.
Description
Keywords
Aterosclerose Doença Arterial Coronária Fatores de Risco Mulheres Pós-Menopausa