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(Circulation. 2005;111:1455.)
© 2005 American Heart Association, Inc.
Issue Highlights
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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RISK OF CARDIOVASCULAR DISEASE BY HYSTERECTOMY STATUS, WITH AND WITHOUT OOPHORECTOMY: THE WOMEN’S HEALTH INITIATIVE OBSERVATIONAL STUDY, by Howard et al. |
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It has long been appreciated that women who have undergone hysterectomy with or without oophorectomy have excess cardiovascular disease morbidity and mortality. Investigators have speculated that the deficiencies in endogenous hormones produced by the uterus and ovaries as well as alteration in iron stores might contribute to the unfavorable outcome. To gain further insights into factors that contribute to cardiovascular disease in women after hysterectomy, researchers analyzed the geographically diverse Women’s Health Initiative Observational database of almost 90 000 women. The investigators confirmed the observation that hysterectomy predicted a risk of cardiovascular disease events and total mortality; however, they noted that black, Hispanic, and American Indian women had higher hysterectomy rates than their white counterparts. In addition, women who had undergone hysterectomy had an unfavorable risk factor profile, including a higher prevalence of hypertension, diabetes, obesity, and high cholesterol and lower education, income, and physical activity levels. Of note, the apparent increased risk of hysterectomy was significantly reduced after adjusting for race/ethnicity and cardiovascular risk factors. Although observational in design, the present study may help reassure patients that hysterectomy per se may not markedly alter cardiovascular risk. One possible clinical implication of the present study is that patients and clinicians might view the advent of hysterectomy as an opportunity to review cardiovascular disease risk factor burden and pursue risk factor modification when appropriate. See p 1462.
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RISK OF WORSENING RENAL FUNCTION WITH NESIRITIDE IN PATIENTS WITH ACUTELY DECOMPENSATED HEART FAILURE, by Sackner-Bernstein et al. |
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Nesiritide is a commonly used treatment for patients with acute decompensated heart failure in whom renal function is an identified prognostic factor. Sackner-Bernstein
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