Cardiovascular disease, this is one of the long term consequences of being in the menopause. Cardiovascular disease is by far the most common cause of death in the postmenopausal woman, accounting for over 500,000 deaths each year. As you can see based on this pie graft, that it accounts for 45% of deaths versus breast cancer with which women are very concerned with, which only accounts for about 4% of deaths. About 1 in 9 women will develop some type of coronary artery disease during this time, and as I said, six times as many women die from heart disease versus those from breast cancer.
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There are certain things that we can do to change the risks for cardiovascular disease, however, things such as age, family history, race and ethnicity are something we can’t do much about, but smoking, alcohol use, the use of more than two alcoholic beverages on a daily basis, life style such as sedentary life style and weight loss are very important counseling tools for our patient’s in the prevention of cardiovascular disease. Some treatable medical conditions such as diabetes, hypertension, and dyslipidemia, elevation of the LDL and the triglycerides are also very important to get under control during this time. It’s also a very complex disease, we used to think years ago that it was just based on the lipids, we now know it’s not just lipid metabolism that’s involved in cardiovascular disease, but instead, based on changes in the coagulation factors, carbohydrate metabolism and the actual vascular tone of the vessels of the heart, so we now know that lipid metabolism and dysfunction of lipid metabolism only really accounts for 25% of the pathogenesis of cardiovascular disease. It’s important that we try to optimize our life style to enhance our lipid profiles, but there are other things that are also very important that can be affected by life style that can change, for example, insulin sensitivity, just weight loss alone would decrease a woman’s insulin sensitivity but coagulation factors and vascular tone are also very much affected by the lack of estrogen within the body. The Nurse’s Health Trial also found that estrogen versus estrogen and progesterone are both equally effective in decreasing cardiovascular disease, the mechanism being primarily through lipids and vascular tone. It was thought many years ago that the addition of progesterone would be a negative impact, but we have not found that to be true and many large scale studies have found that to be the case. Viagra Jelly at cheapest canadian pharmacy.
Overall survival, in studies looking at women who are at risk for cardiovascular disease or have early signs of cardiovascular disease that are treated with an estrogen replacement over a 10 year period, they have an overall increased chance of survival versus those who have been treated with a placebo. Now, there was a recent study called the Hearse study in which woman were enrolled who already had advanced cardiovascular disease, and we found a lot of problems with that study as well as many of the breast cancer studies that are now emerging into the media, one of which is that the population that was studied was very advanced in their heart disease, perhaps beyond anything that many medications can do for them. The other factor is that the women that were enrolled were of much older age than the average women that are studied, and then perhaps some of the statistics that were used were also a little bit flawed, so you have to be very careful when you look at some of these studies before you change the course of direction for a woman, particularly if she is already on hormone replacement, doing very well for that on the hormone replacement and is being given that for a specific purpose in life to decrease or reduce her risk of developing long term health problems. Instead, you look very closely at the studies, you see if there is a problem and if your patient would apply to that before withdrawing any kind of hormone replacement. Canadian viagra