Management of cardiovascular risk in the peri-menopausal woman: A consensus statement of European cardiologists and gynaecologists

Peter Collins, Guiseppe Rosano, Catherine Casey, Caroline Daly, Marco Gambacciani, Peyman Hadji, Risto Kaaja, Tomi Mikkola, Santiago Palacios, Richard Preston, Tabassome Simon, John Stevenson, Marco Stramba-Badiale

Research output: Contribution to journalArticlepeer-review

134 Scopus citations

Abstract

Cardiovascular risk is poorly managed in women, especially during the menopausal transition when susceptibility to cardiovascular events increases. Clear gender differences exist in the epidemiology, symptoms, diagnosis, progression, prognosis, and management of cardiovascular risk. Key risk factors that need to be controlled in the peri-menopausal woman are hypertension, dyslipidaemia, obesity, and other components of the metabolic syndrome, with the avoidance and careful control of diabetes. Hypertension is a particularly powerful risk factor and lowering of blood pressure is pivotal. Hormone replacement therapy is acknowledged as the gold standard for the alleviation of the distressing vasomotor symptoms of the menopause, but the findings of the Women's Health Initiative (WHI) study generated concern for the detrimental effect on cardiovascular events. Thus, hormone replacement therapy cannot be recommended for the prevention of cardiovascular disease. Whether the findings of WHI in older post-menopausal women can be applied to younger peri-menopausal women is unknown. It is increasingly recognized that hormone therapy is inappropriate for older post-menopausal women no longer displaying menopausal symptoms. Both gynaecologists and cardiovascular physicians have an important role to play in identifying peri-menopausal women at risk of cardiovascular morbidity and mortality and should work as a team to identify and manage risk factors such as hypertension.

Original languageEnglish (US)
Pages (from-to)2028-2040
Number of pages13
JournalEuropean heart journal
Volume28
Issue number16
DOIs
StatePublished - Aug 1 2007

Keywords

  • Cardiology
  • Cardiovascular prevention
  • Cardiovascular risk
  • Gynaecology
  • Hormones
  • Hypertension
  • Menopause
  • Metabolic syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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