Management of Cardiovascular Risk in Perimenopausal Women with Diabetes
The transition towards menopause marks a period of surging risk for the progression of Cardio-vascular diseases which can be partly explained by increasing age, levels of blood pressure and glucose.
Study proposes that hormonal changes and LDL also contribute to increased risk. However, it has been observed that estrogen based therapies do not reduce the risk of CVD. Catherine Kim has reviewed the article titled “Management of Cardiovasculat Risk in Perimenopausal Women with Diabetes.” A summary of the findings is given below.
Objective:
The objective of the review is to elaborate the transitions in CVD risk factors that appear during the menopausal period and also to evaluate the information available on the prevalence of CVD in menopausal stages.
It also highlights the influence of estrogen therapy on CVD outcomes and markers of atherosclerosis such as coronary artery calcification and carotid intima media thickness.
Study risk engines to notify decisions regarding estrogen in newly menopausal women and summarize the risk factor targets and pharmacological recommendations for people with diabetes.
Method:
The review has been summarized post scanning scientific evidence.
Findings:
Menopause results in alteration of several parameters. Weight gain does not have any direct association with menopause but redistribution of visceral fat is observed. This thereby leads to an imbalance of lipid profiles resulting in dyslipidemia and subsequent insulin resistance.
Altered levels of sex hormones result in altered vascular reactivity and endothelial dysfunction. The Study of Women’s Health across the nation which was a longitudinal multicentre cohort study suggests that a reduction in estradiol has a negative influence on lipid profiles.
The pervasiveness of CHD in women with diabetes under the age of 45 is less pronounced but sees a rapid surge post the age of 45.
This review also featured that neither estrogen therapy alone nor estrogen with progestin therapy reduced the risk of CHD but risk of stroke was increased.
Besides, SGLT-2 inhibitors and the glucagon-like peptide GLP-1 receptor agonists have been associated with decreased risk of CVD events among people with diabetes, and those with a history of CVD.
Since Diabetes is accompanied with a potential of developing blood pressure; it was observed that ACE inhibitors help in reducing CVD risk.
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