Publish date: May 29, 2018
By Andrew D. Bowser, Cardiology News
New perspective on sex steroids and CV risk
In postmenopausal women, a higher level of testosterone in comparison to estrogen may increase the cardiovascular disease risk later in life, results of a recent analysis suggest.
A higher ratio of testosterone to estradiol was associated with the development of cardiovascular disease, coronary heart disease, and heart failure in postmenopausal women, according to results from an analysis based on 2,834 postmenopausal women in MESA (Multi-Ethnic Study of Atherosclerosis).
In addition, total testosterone levels were associated with increased cardiovascular disease and coronary heart disease, while estradiol is associated with a reduced risk of coronary heart disease and heart failure with reduced ejection fraction, investigators reported in the Journal of the American College of Cardiology.
Without any interventional studies as guidance, it’s not clear what the “best strategy” would be to modify sex hormone levels and reduce cardiovascular disease risk, wrote investigator Di Zhao, PhD, of the department of epidemiology at Johns Hopkins University Bloomberg School of Public Health, Baltimore, and her study coauthors.
“Nonetheless, a more androgenic sex hormone profile may identify a woman at higher risk for cardiovascular disease who may benefit from other risk-reducing strategies,” Dr. Zhao and her colleagues wrote in their report.
The postmenopausal women included in this analysis all had baseline measurements of testosterone, estradiol, dehydroepiandrosterone, and sex hormone–binding globulin levels between 2000 and 2002, according to the report.
After more than 12 years of follow-up, investigators found that a higher total testosterone to estradiol ratio was independently associated with an increased risk of incident cardiovascular disease (hazard ratio, 1.19; 95% confidence interval, 1.02-1.40), coronary heart disease (HR, 1.45; 95% CI, 1.19-1.78), and heart failure (HR, 1.31; 95% CI, 1.01-1.70).
Posted by Dr.Buruiana on JANUARY 19, 2018
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By Ian Lacy
Publish date: DECEMBER 6, 2017 Ob.Gyn.News
A recent study published in the NEJM shows that women who use hormonal contraceptives including some types of IUD’s for more than a year have a 20%higher risk of breast cancer.
The absolute risk is still very low. It translates in one extra case of Brest cancer for every 7690 women using hormonal contraceptives for one year.
The risk is still less than a tenth of one percent, for a 40 year old it means a change from 1 in 69 to 1 in 57.
ACOG reports that the increase risk was equal to the increase from drinking alcohol.
This is an observational study and this new evidence does not change what we previously know about hormonal contraceptives and breast cancer risk.
The small risk has to be set against the benefits which includes prevention of unwanted pregnancies and “substantial reduction in the risk of ovarian , endometrial and colorectal cancer in life”.
NOV. 16, 2017 NY Times
Using accelerometers to precisely measure physical activity, researchers have found that even very light exercise, well below the generally recommended levels, reduces mortality in older women.
The scientists had 6,382 women ages 63 to 99 wear an accelerometer for seven consecutive days, waking and sleeping, except when bathing or swimming. Using this data, they were able to precisely quantify levels of activity without having to rely on self-reports, which can be unreliable.
The study, in the Journal of the American Geriatrics Society, followed the women’s health for an average of 3.1 years, during which time there were 450 deaths.
They found that for each 30 minute a day increase in moderate-to-vigorous physical activity, there was a 39 percent decrease in all-cause mortality. But they also found that 30 minutes of even very light activity — doing light household chores, walking slowly over short distances — was tied to a 12 percent reduction in mortality.
“The results apply to all women, all races, regardless of weight and even for women over 80,” said the senior author, Andrea Z. LaCroix, a professor of epidemiology at the University of California, San Diego. “You do not have to be a marathon runner to benefit from physical activity. We hope that physical activity guidelines will recognize light activity as an evidence-based way to lower the risk for death.”