Kajian Naratif: Kesehatan Kardiovaskuler pada Masa Menopause
Narative Review: Cardiovascular Health During Menopause
DOI:
https://doi.org/10.35473/ijm.v7i2.3190Abstract
Menopause (MP) is associated with a significant increase in blood pressure, body mass index (BMI), obesity, and body fat distribution. At this time, women have a higher risk of cardiovascular disease (PKV) than men according to their age due to reduced levels of endogenous estrogen. This article aims to examine the role of estrogen during MP in relation to the risk of cardiovascular disorders and estrogen replacement therapy. Articles were obtained from PubMed, and ScienceDirect articles, using the keywords “estrogen and MP”; “estrogen and lipid metabolism”, “estrogen and cardiovascular”, and “menopausal hormone therapy”. The final set includes 82 academic articles published from 1998-2024. Estrogens produce increased lipid metabolism, have effects on biomarkers of vascular activity by activating vasodilator pathways and inhibiting vasoconstrictor pathways mediated by the sympathetic nervous system and angiotensin. Estrogen plays an important role in regulating the cardiovascular system. From the perspective of oxidative stress provides a strategy for the treatment of cardiovascular disease in postmenopausal women.
Abstrak
Menopause (MP) dikaitkan dengan peningkatan signifikan tekanan darah, indeks massa tubuh (IMB), obesitas, dan distribusi lemak tubuh, pada masa ini perempuan memiliki resiko penyakit kardiovaskuler (PKV) lebih tinggi dibanding laki-laki sesuai usianya akibat berkurangnya kadar estrogen endogen. Artikel ini bertujuan untuk mengkaji peran estrogen pada masa MP dalam hubungannya dengan resiko gangguan kardiovaskuler serta terapi sulih estrogen. Artikkel-artikel diperoleh dari PubMed, dan ScienceDirect, menggunakan kata kunci “estrogen dan MP”; “estrogen dan metabolism lipid”, “estrogen dan kardiovaskuler”, “terapi hormon MP”. Set terakhir mencakup 82 artikel akademis tahun terbit 1998-2024. Estrogen meningkatkan metabolisme lipid, memiliiki efek pada biomarker aktivitas pembuluh darah dengan mengaktivasi jalur vasodilator dan menghambat jalur vasokonstriktor yang dimediasi oleh sistem saraf simpatis dan angiotensin. Estrogen berperan penting dalam pengaturan sistem kardiovaskuler. Dari perspektif stres oksidatif memberikan strategi untuk pengobatan penyakit kardiovaskular pada wanita MP.
Downloads
References
Ahmad A., & Oparil S. (2017). Hypertension in Women: Recent Advances and Lingering Questions. Hypertens (Dallas, Tex. : 1979), 70(1), 19–26.
Ambikairajah A, Walsh E, CN. (2019). Lipid Profile Differences during Menopause: a Review with Meta-Analysis. Menopause 26 (11), 1327–1333.
Anagnostis P, Stevenson JC, Crook D, Johnston DG, Godsland IF. (2016). Effects of gender, age and menopausal status on serum apolipoprotein concentrations. Clin. Endocrinol., 85(5), 733–740.
Anagnostis P, Bitzer J, Cano A, Ceausu I, Chedraui P, Durmusoglu F, et al. (2020). Menopause symptom management in women with dyslipidemias: An EMAS clinical guide,. Maturitas, 135, 82-88.
Arnal JF, Lenfant F, Metivier R, Flouriot G, Henrion D, Adlanmerini M., et al. (2017). Membrane and Nuclear Estrogen Receptor Alpha Actions: From Tissue Specificity to Medical Implications. Physiol. Rev, 97(3), 1045–1087.
Aryan L, Younessi D, Zargari M, Banerjee S, Agopian J, Rahman S., et al. (2020). The Role of Estrogen Receptors in Cardiovascular Disease. Int. J. Mol. Sci., 21(12), 4314.
Ayres S, Abplanalp W, Liu JH, Subbiah MT. (1998). Mechanisms involved in the protective effect of estradiol-17beta on lipid peroxidation and DNA damage. Am. J. Physiol, 274(6), E-1002–E-1008.
Baron, M, (2013). Cholesterol and atherosclerosis: modulation by oestrogen. Curr Opi. Lipidol, 24(3), 214–220.
Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. (2017). Update: A Report From the American Heart Association. Circulation, 135(10), E-146–E603.
Bittner V. (2009). Menopause, age, and cardiovascular risk: a complex relationship. J. Am. Coll. Cardiol, 54(25), 2374–2375
Buscato M, Davezac M, Zahreddine R, Adlanmerini M, Métivier R, Fillet M, et al. (2021). Estetrol prevents Western diet–induced obesity and atheroma independently of hepatic estrogen receptor α. Am. J. Physiol. Metab. 320, E-19–29.
Cortés Yamnia I, Barinas-Mitchell E, Suder Egnot N, Bhasin S, Jasuja R, Santoro N, et al.. (2020). Associations of Endogenous Sex Hormones with Carotid Plaque Burden and Characteristics in Midlife Women. J. Clin. Endocrinol. Metab. 105.
Davey DA, (2012). Update: estrogen and estrogen plus progestin therapy in the care of women at and after the menopause. Women’s Health (London, England), 8(2), 169–189.
de Padua Mansur A, Silva TC, Takada JY, Avakian SD, Strunz CM, Machado César L A, et al. (2012). Long-term Prospective Study of the Influence of Estrone Levels on Events in Postmenopausal Women with or at High Risk for Coronary Artery Disease. Sci. World J. (-6-4), 363595.
Di Giosia P, Giorgini P, Stamerra CA, Petrarca M, Ferri C, Sahebkar A, (2018). Gender Differences in Epidemiology, Pathophysiology, and Treatment of Hypertension. Curr. Atheroscler Rep., 20(3), 13.
Díaz A, López-Grueso R, Gambini J, Monleón D, Mas-Bargues C, Abdelaziz K, et al. (2019). Sex Differences in Age-Associated Type 2 Diabetes in Rats, Role of Estrogens and Oxidative Stress. Oxid Med Cell Longev. 1 - 13.
Dong J, Yang S, Zhuang Q, Sun J, Wei P, Zhao X, et al. (2021). The Associations of Lipid Profiles With Cardiovascular Diseases and Death in a 10-Year Prospective Cohort Study. Front Cardiovasc Med., 8, 745539.
El Khoudary S. R. (2017). HDL and the menopause. Current opinion in lipidology, 28(4), 328–336
El Khoudary SR, Wang L, Brooks MM, Thurston RC, Derby CA, Matthews KA. (2016). Increase HDL-C level over the menopausal transition is associated with greater atherosclerotic progression. J. Clin. Lipidol, 10(4), 962–969.
El Khoudary SR, Greendale G, Crawford SL, Avis NE, Brooks MM`, Thurston RC, et al.. (2019). The menopause transition and women’s health at midlife: a progress report from the Study of Women’s Health Across the Nation (SWAN). Menopause.;26(10):1213–27.
Eraikhuemen N, Lazaridis D, Dutton MT, (2021). Emerging Pharmacotherapy to Reduce Elevated Lipoprotein(a) Plasma Levels. Am. J. Cardiovas Drugs : Drugs, Devices, and Other Interventions, 21(3), 255–265.
Fairweather, D. (2014). Sex Differences in Inflammation during Atherosclerosis. Clin. Med. Insights: Cardiol. 8, 49–59.
Fairweather, D. (2014). Sex Differences in Inflammation during Atherosclerosis. Clin. Med. Insights: Cardiol. 8, 49–59.
Feingold KR. (2024). Introduction to Lipids and Lipoproteins. [Updated 2024 Jan 14]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK305896/.
Fernandez ML, & Morillo AM, (2016). Postmenopausal Women Have Higher HDL and Decreased Incidence of Low HDL than Premenopausal Women with Metabolic Syndrome. Healthcare (Basel).;4(1):20.
Fredette NC, Meyer MR, Prossnitz ER. (2018). Role of GPER in estrogen-dependent nitric oxide formation and vasodilation. J. Steroid Biochem. Mol Biol, 176, 65–72.
Fryar CD, Ostchega Y, Hales CM, Zhang G, Kruszon-Moran, D. (2017). Hypertension Prevalence and Control Among Adults: United States, 2015-2016. NCHS Data Brief, (289), 1-8.
Gómez EC & Mora QS. (2013). HRT decreases DNA and lipid oxidation in postmenopausal women. Climacteric, 16(1), 104–110.
Gourdy P, Guillaume M, Fontaine C, Adlanmerini M, Montagner A, Laurell H, et al. (2018). Estrogen receptor subcellular localization and cardiometabolism. Mol. Metab, 15, 56–69.
Howard BV, & Rossouw JE, (2013). Estrogens and cardiovascular disease risk revisited: the Women’s Health Initiative. Curr. Opin Lipidol, 24(6), 493–499.
Papaconstantinou J,(2019). The Role of Signaling Pathways of Inflammation and Oxidative Stress in Development of Senescence and Aging Phenotypes in Cardiovascular Disease. Cells. 8(11):1383.
Ji H, Kim A, Ebinger JE, Niiranen TJ, Claggett BL, Bairey Merz CN, Cheng S. (2020). Sex Differences in Blood Pressure Trajectories Over the Life Course. JAMA Cardiol, 5(3), 19–26.
Kamińska MS, Schneider-Matyka D, Rachubińska K, Panczyk M, Grochans E, Cybulska AM. (2023). Menopause Predisposes Women to Increased Risk of Cardiovascular Disease. J. Clin. Med., 12(22), 7058.
Kander MC, Cui Y, Liu Z. (2017). Gender difference in oxidative stress: a new look at the mechanisms for cardiovascular diseases. J. Cell. Mol. Med., 21(5), 1024–1032
Keck C, & Taylor M. (2018). Emerging Research on the Implications of Hormone Replacement Therapy on Coronary Heart Disease. Curr. Atheroscler Rep, 20(12), 57.
Ki EY, Hur SY, Park JS, Do Han K, Park YG. (2016). Differences in the Lipid Profile and Hormone Replacement Therapy Use in Korean Postmenopausal Women: the Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012. Arch. Arch. Gynecol. Obstet. 294 (1), 165–173.
Kronenberg F, Mora S, Stroes ESG, Ference BA, Arsenault BJ, Berglund L, et al. (2022). Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. Eur. Heart J., 43(39), 3925–3946.
Lee JS, Chang PY, Zhang Y, Kizer JR, Best LG, Howard, B. V (2017). Triglyceride and HDL-C Dyslipidemia and Risks of Coronary Heart Disease and Ischemic Stroke by Glycemic Dysregulation Status: The Strong Heart Study. Diab. Care 40 (4), 529–537.
Li Q, Geng X, Zheng W, Tang J, Xu B, Shi Q. (2012). Current understanding of ovarian aging. Sci. China. Life Sci., 55(8), 659–669.
Liu S, Anamika Bajpai A, Hawthorne EA, Bae Y, Castagnino O, Monslow J, et al. (2019). Cardiovascular protection in females linked to estrogen-dependent inhibition of arterial stiffening and macrophage MMP12,. JCI Insight, 4,1,.
Manson JE, Aragaki AK, Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, et al. (2017). Menopausal Hormone Therapy and Long-Term All-Cause and Cause-specific Mortality: The Women’s Health Initiative Randomized Trials. JAMA, 318 (10), 927–938.
Marques-Lopes J, Tesfaye E, Israilov S, Van Kempen TA, Wang G, Glass MJ, et al. (2017). Redistribution of NMDA Receptors in Estrogen-Receptor-β-Containing Paraventricular Hypothalamic Neurons following Slow-Pressor Angiotensin II Hypertension in Female Mice with Accelerated Ovarian Failure. Neuroendocrinol, 104(3), 239–256..
Matthews KA, El Khoudary SR, Brooks MM, Derby CA., Harlow SD, Barinas-Mitchell EJ, et al, (2017). Lipid Changes Around the Final Menstrual Period Predict Carotid Subclinical Disease in Postmenopausal Women. Stroke, 48(1), 70–76.
May-Panloup P, Boucret L, Chao de la Barca JM, Desquiret-Dumas V, Ferré-L’Hotellier VC, et al. (2016). Ovarian ageing: the role of mitochondria in oocytes and follicles. Hum. Reprod. Update, 22(6), 725–743.
Meyer M, Prossnitz ER, Barton, M. (2011). GPER/GPR30 and Regulation of Vascular Tone and Blood Pressure. Immunol. Endocr. Metab. Agents Med. Metab. Agents Med. Chem. 11, 255–261.
Nair AR, Pillai AJ, Nair N. (2021). Cardiovascular Changes in Menopause. Curr. Cardiol. Rev., 17(4), E-230421187681.
Nakamura T, Naguro I, Ichijo H. (2019). Iron homeostasis and iron-regulated ROS in cell death, senescence and human diseases. Bioch Biophys Acta. Gen. Subj, 1863(9), 1398–1409.
Nichols M, Townsend N, Scarborough P, Rayner M. (2014). Cardiovascular disease in Europe 2014: epidemiological update. European Heart Journal, 35(42), 2929.
Nie G, Yang X, Wang Y, Liang W, Li X, Luo Q, et al. (2022). The Effects of Menopause Hormone Therapy on Lipid Profile in Postmenopausal Women: A Systematic Review and Meta-Analysis. Front. Pharmacol, 13, 850815.
Nii S, Shinohara K, Matsushita H, Noguchi Y, Watanabe K, WA. (2016). Hepatic Effects of Estrogen on Plasma Distribution of Small Dense Low-Density Lipoprotein and Free Radical Production in Postmenopausal Women. J. Atheroscler. Thromb. 23 (7), 810–818
Palmisano BT, Zhu L, Stafford JM. (2017). Role of Estrogens in the Regulation of Liver Lipid Metabolism. Adv. Exp Med Biol, 1043, 227–256.
Palmisano BT, Zhu L, Eckel RH, Stafford JM. (2018). Sex differences in lipid and lipoprotein metabolism. Mol. Metab, 15, 45–55.
Paterni I, Granchi C, Katzenellenbogen JA, Minutolo F. (2014). Estrogen receptors alpha (ERα) and beta (ERβ): subtype-selective ligands and clinical potential. Steroids, 90, 13–29.
Pelekanou V, Kampa M, Kiagiadaki F, Deli A, Theodoropoulos P, Agrogiannis, et al, (2016). Estrogen anti-inflammatory activity on human monocytes is mediated through cross-talk between estrogen receptor ERα36 and GPR30/GPER1. J. Leukoc. Biol, 99(2), 333–347. J. Leukoc. Biol, 99(2), 333–347.
Prokai L, Rivera-Portalatin NM, Prokai-Tatrai K. (2013). Quantitative Structure-Activity Relationships Predicting the Antioxidant Potency of 17β-Estradiol-Related Polycyclic Phenols to Inhibit Lipid Peroxidation. Int. J. Mol. Sci., 14, 1443-1454.
Pu D, Tan R, Yu Q, Wu J. (2017). Metabolic Syndrome in Menopause and Associated Factors: a Meta-Analysis. Climacteric 20 (6), 583–591.
Qureshi R, Picon-Ruiz M, Aurrekoetxea-Rodriguez I, Nunes de Paiva V, D’Amico M, Yoon H, et al. (2020). The Major Pre- and Postmenopausal Estrogens Play Opposing Roles in Obesity-Driven Mammary Inflammation and Breast Cancer Development. Cell Metab., 31(6), 1154–1172.E9.
Ramirez LA, & Sullivan JC (2018). Sex Differences in Hypertension: Where We Have Been and Where We Are Going. Am. J. Hypertens, 31(12), 1247–1254.
Rhee EJ, Byrne CD, Sung KC. (2017). The HDL cholesterol/apolipoprotein A-I ratio: an indicator of cardiovascular disease. Cur. Opi Endocrinol, Diab.Obes, 24(2), 148–153.
Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, Bravata DM, et al. (2012). Heart disease and stroke statistics--2012 update: a report from the American Heart Association. Circulation, 125(1), E-2–E-220.
Rosenson RS, Brewer HB, Jr, Davidson WS, Fayad ZA, Fuster V, Goldstein J, et al. (2012). Cholesterol efflux and atheroprotection: advancing the concept of reverse cholesterol transport. Circulation, 125(15), 1905–1919.
Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al. (2017). Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. JACC, 70(1), 1–25.
Savva C, & Korach-André M. (2020). Estrogen Receptor beta (ERβ) Regulation of Lipid Homeostasis-Does Sex Matter?. Metabolites, 10(3), 116.
Segarra TJ, Ritchie M, Zehtabchi S. (2018). Hormone Therapy for Primary Prevention of Cardiovascular Disease in Postmenopausal Women. Am. Fam Physic, 98(7), .
Shen D, Tian L, Shen T, Sun H, Liu P. (2018). Alpha-Lipoic Acid Protects Human Aortic Endothelial Cells against H2O2-Induced Injury and Inhibits Atherosclerosis in Ovariectomized Low Density Lipoprotein Receptor Knock-out Mice. Cell. Physiol. Biochem. 2018, 47, 2261–2277.
Somani YB, Pawelczyk JA, De Souza MJ, Kris-Etherton PM, Proctor DN. (2019). Aging women and their endothelium: probing the relative role of estrogen on vasodilator function. Am. J. Physiol. Heart Cir. Physiol., 317(2), H395–404.
Song JJ, Ma Z, Wang J, Chen LX, Zhong JC. (2020). Gender Differences in Hypertension. J. Cardiovas. Transl. Res. 13(1), 47–54.
Stevenson JC, Chines A, Pan K, Ryan KA, Mirkin S. (2015). A Pooled Analysis of the Effects of Conjugated Estrogens/Bazedoxifene on Lipid Parameters in Postmenopausal Women from the Selective Estrogens, Menopause, and Response to Therapy (SMART) Trials. J. Clin. Endocrinol. Metab. 100 (6), 2329–2338.
Subramanya V, Zhao D, Ouyang P, Ying W, Vaidya D, Ndumele CE, et al. (2019). Association of Endogenous Sex Hormone Levels with Coronary Artery Calcium Progression Among post-menopausal Women in the Multi-Ethnic Study of Atherosclerosis (MESA). J. Cardiovasc. Comput. Tomogr 13, 41–47.
Sun Y, Yu Q, Shen Q, Bai W, Kang J. (2016). Black Cohosh Ameliorates Metabolic Disorders in Female Ovariectomized Rats. Rejuvenation Res. 19(3), 204–214.
Tandon VR, Mahajan A, Sharma A. (2010). Prevalence of Cardiovascular Risk Factors in Postmenopausal Women: A Rural Study. J. Midlife Health 1 (1), 26–29.
Thurston RC, Bhasin S., Chang Y, Barinas-Mitchell E, Matthews KA, Jasuja R, et al. (2018). Reproductive Hormones and Subclinical Cardiovascular Disease in Midlife Women. J. Clin. Endocrinol. Metab. 103, 3070–3077.
van Dam-Nolen DHK, van Dijk AC, Crombag GAJC, Lucci C, Kooi ME, Hendrikse J, et al. (2021). Lipoprotein(a) Levels and Atherosclerotic Plaque Characteristics in the Carotid Artery: The Plaque at RISK (PARISK) Study. Atherosclerosis 329, 22–29.
Wang X, Magkos F, Mittendorfer B. (2011). Sex differences in lipid and lipoprotein metabolism: it’s not just about sex hormones. J. Clin. Endocrinol Metab 96(4), 885–893.
Wellons M, Ouyang P, Schreiner PJ, Herrington DM, Vaidya D. (2012). Early menopause predicts future coronary heart disease and stroke: the Multi-Ethnic Study of Atherosclerosis. Menopause (New York, N.Y.), 19(10), 1081–1087.
Wenger NK, Arnold A, Bairey Merz CN, Cooper-DeHoff RM, Ferdinand KC, Fleg JL, et al. (2018). Hypertension Across a Woman’s Life Cycle. J Am Coll Cardiol, 71(16), 1797–1813.
Woo CY, Jang JE, Lee SE, Koh EH, Lee K, (2019). Mitochondrial Dysfunction in Adipocytes as a Primary Cause of Adipose Tissue Inflammation. Diab. Metab. J. 43, 247–256.
Xu T, Ding W, Ji X, Ao X, Liu Y, Yu W, Wang J. (2019). Oxidative Stress in Cell Death and Cardiovascular Diseases. Oxid Med Cell Longev, 9030563.
Xue B, Zhang Z, Beltz TG, Johnson RF, Guo F, Hay M, et al, (2013). Estrogen receptor-β in the paraventricular nucleus and rostroventrolateral medulla plays an essential protective role in aldosterone/salt-induced hypertension in female rats. Hypertens. (Dallas, Tex. : 1979), 61(6), 1255–1262.
Yanes LL, & Reckelhoff JF. (2011). Postmenopausal hypertension. Am. J. Hypertens, 24(7), 740–749.
Yoon SS, Carroll MD, Fryar CD. (2015). Hypertension Prevalence and Control Among Adults: United States, 2011-2014. NCHS Data Brief, (220), 1–8
Downloads
Published
How to Cite
Issue
Section
License
Copyright notice:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.