Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0600142 (hot flushes)
 1,242 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hormone-replacement therapy for postmenopausal women has associated benefits and risks. The advantages of the administration of estrogen to postmenopausal women include preventing or reversing the atrophic changes of the genitourinary system, slowing of facial aging, relieving hot flushes and psychological symptoms, preventing atherosclerotic heart disease and retarding the development of osteoporosis. The disadvantages of the administration of estrogen to postmenopausal women include rare but serious clinical sequelae associated with the ingestion of the synthetic estrogen when it is one component of the combination oral contraceptives, increased risk of cancer developing in the estrogen-dependent organs and uterine bleeding. The benefits of long-term cyclic estrogen-gestagen therapy in preventing osteoporosis far outweigh the risks.
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PMID:The menopause. 709 Mar 70

Menopause signals a transition from the reproductive stage to the nonreproductive stage in a woman's life. Common problems that are relatively acute include hot flushes, menstrual irregularity, and atrophic changes in the vagina and the urinary tract. A variety of therapies, including hormone replacement, can be used to treat these conditions. In addition, the delayed problems of osteoporosis and arteriosclerotic coronary artery disease increase in incidence and severity after menopause. A number of lifestyle changes are beneficial in these conditions, both acutely and to retard the development of several important diseases. The use of hormone therapy and other treatments should be individualized and fully discussed with each patient. Most importantly, the additional benefits and risks of each form of treatment, plus the beneficial lifestyle changes, should also be discussed.
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PMID:Management of menopause. 937 Oct 4

The incidence of cardiovascular disease is lower in women before the menopause compared with men, while menopausal women have an incidence of coronary disease similar to that of men of the same age. This is mainly dependent upon oestrogen deficiency. Large-scale epidemiological studies have demonstrated that oestrogen replacement therapy leads to approximately 50 per cent reduction of cardiovascular disease in women taking hormones, compared with untreated women. Multiple mechanisms have been proposed to explain the cardiovascular risk reduction observed in women on oestrogen therapy. Oestrogens positively affect plasma lipids and exert a beneficial effect upon carbohydrate metabolism and the haemocoagulation profile. Oestrogens may also have anti-atherogenic properties. Recent in vitro studies have demonstrated that oestrogens may positively influence all the steps involved in the formation of the atherosclerotic plaque (accumulation of cholesterol in the arterial wall, arterial smooth muscle cell proliferation, platelet aggregation, collagen and elastin production). Angiographic studies conducted in humans have demonstrated that women on oestrogens have significantly less coronary disease and less severe occlusion scores compared with women not taking hormone replacement therapy. Animal and human studies have shown that oestrogens act as vasodilating substances. Endothelium-dependent mechanisms have been identified and imply that oestrogens act through the endothelial release, mainly, of nitric oxide, a potent vasodilating substance which has been identified with EDRF (endothelium derived relaxing factor). More recently, oestrogens have been shown to affect also the vascular tone in the absence of the endothelium. Therefore, endothelium-independent mechanisms could be involved in the pathogenesis of the oestrogens' vascular effects. There is evidence that oestrogens have calcium antagonistic properties; this mechanism may be responsible for the reduction of peripheral vascular resistance observed in women on hormone replacement therapy and may slow the progression of coronary artery disease. The menopausal age is characterized by an imbalance of the neurohormonal system. Sudden increases of plasma catecholamines are evident when women have hot flushes, a typical clinical sign of the menopausal period. The abnormal release of catecholamines may reduce coronary flow reserve and increase peripheral vascular resistance and, therefore, may be dangerous for the heart. It has been shown, by means of the study of heart rate variability, that oestrogens are effective in modulating the neurohormonal system. The reduction of sympathetic tone has beneficial effects on coronary flow reserve and may be important in explaining the cardioprotective effect of oestrogens. Peripheral and coronary vasodilation observed in women on hormone replacement therapy might be also due to the inhibition of the release of vasoconstrictor factors such as endothelin-1 by oestrogens. Therefore, oestrogens protect the heart against coronary artery disease and they are now regarded as being as important as aspirin and antihypertensive drugs were in the past. Hormone replacement therapy should be considered in every menopausal woman to possibly prevent the occurrence of cardiovascular disease or, if already present, to slow its progression.
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PMID:Oestrogens and the heart. 1050 Apr 55

HRT should not be used for prevention of cardiovascular and coronary artery disease. While estrogen plays a role in osteoporosis, the bisphosphonates and raloxifene demonstrate equal or superior efficacy for prevention and treatment, compared with HRT. HRT decreases the risk of colon cancer but increases a woman's chance of developing breast cancer. Short-term use of low-dose HRT remains a valid option for management of menopausal symptoms, especially hot flushes. Pharmacists can help patients interpret the information in the press and guide them in weighing the risks and benefits as they evaluate HRT for use in their own individual situations.
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PMID:MenoPAUSE: taking a second look at the role of HRT. 1462 25

Although the exact etiology of hot flushes and night sweats has not been fully clarified, the intriguing question whether vasomotor symptoms (VMS) are markers of coronary artery disease risk has been evaluated in several studies. Surrogate metabolic and hemodynamic parameters point at adverse alterations in flushers, but the results related to clinical endpoints are not unidirectional. Recent relevant data come from the Women's Health Initiative (WHI) observational study (60 000 women, mean age 63 years, mean follow-up period 10 years). Women with VMS only at onset of menopause but not at enrollment to the WHI study had a modest, yet significant decreased risk of stroke, total cardiovascular disease events, and all-cause mortality, compared with women having no VMS. Contrarily, women with late VMS (reported at enrollment to the study but not at onset of menopause) had an increased risk in the above-mentioned parameters. There was no interaction between hormone use and VMS in this respect. This mini-review, which summarizes the relevant data, shows that hot flushes seem to be a marker for physiological alterations that could be associated with cardiovascular disease.
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PMID:Vasomotor symptoms and cardiovascular disease risk. 2184 96

This study aimed to evaluate the differences of prescribing pattern between bisphosphonate and raloxifene users among Korean women with osteoporosis, focusing on the underlying conditions, concurrent medications, nature of healthcare utilization, and regional disparity. We used the Health Insurance Review and Assessment Service National Patients Sample database of the year 2010. Study subjects were defined as female osteoporosis patients aged over 50 years with both the diagnosis of osteoporosis and prescriptions of bisphosphonate or raloxifene. The frequency and the proportion of bisphosphonate and raloxifene were compared using chi-square test and the trend of the proportion using the Cochran-Armitage test. Medications were quantified as defined daily doses per 1,000 patients per day. The prescription pattern was visualized by using the Quantum Geographic Information Systems program. Of the 1,367,367 people who utilized medical services in 2010, the final number of study subjects was 26,881--26,032 (96.8%) bisphosphonate and 849 (3.2%) raloxifene recipients. Raloxifene users were younger than bisphosphonate users and were more frequently patients with a lipid disorder (16.0% vs. 22.1%, p-value < 0.0001), rheumatic disease (4.0% vs. 6.1%, p-value = 0.0024), hot flash (1.8% vs. 6.1%, p <0.0001), and coronary artery disease (1.2% vs. 2.8%, p< 0.0001). The proportion of raloxifene users was higher in tertiary care institutions (21.6% vs. 44.7%, p-value < 0.0001). A regional distribution showed that raloxifene use was higher in the Seoul metropolitan area. These differences in demographic and clinical profiles of each recipient may influence prescription decisions.
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PMID:Comparison of the prescribing pattern of bisphosphonate and raloxifene in Korean women with osteoporosis: from a national health insurance claims database. 2603 Mar

Coronary artery disease (CAD) is still the most common killer of western women. Coronary arteries, expressing estrogen receptors, are a target for estrogen action. Prior to the Women's Health Initiative (WHI) study, postmenopausal hormone therapy (HT) was widely advocated for primary prevention of CAD, but such use was criticized after the WHI publication. However, new data accumulated in the USA and in Europe indicate that the use of estradiol-based HT regimens does not endanger the heart, but rather, it significantly reduces the incidence of CAD events and mortality. This effect may be related to the presence of hot flushes before HT initiation, because they may indicate a greater responsiveness of the cardiovascular system to HT. To get maximal cardioprotective efficacy of HT, a woman should initiate HT as soon as symptoms occur, and preferably within the first 10 postmenopausal years. Recent guidelines for optimal use of HT recommend pauses of HT at 1-2-year intervals to see whether hot flushes and other symptoms still persist. However, new data question the safety of this policy, because acute withdrawals of estradiol from the circulation may predispose to potentially fatal CAD events. All these data support modernized guidelines for optimal HT use.
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PMID:New evidence for cardiac benefit of postmenopausal hormone therapy. 2804 27