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Cardiovascular Protection in Premenopausal Women

Cardiovascular Protection in Premenopausal Women Kannel and Levy,1 commenting on the Framingham findings, which showed that natural menopause, surgical menopause with simple hysterectomy, or surgical menopause with hysterectomy and oophorectomy were associated with similar increases in coronary heart disease (CHD), suggested that an intact uterus might have a role in the protection of premenopausal women. A plausible explanation of these findings might be related to the beneficial effect of iron depletion in menstruating women (ie, the iron hypothesis suggested by Sullivan2 in 1981). The decrease of stored tissue iron caused by recurrent bleeding might also explain the reduced risk of fatal ischemic heart disease seen in patients with hemophilia.3 Furthermore, serum ferritin, a good measurement of body iron stores, emerged as one of the strongest risk factors for progression of carotid atherosclerosis.4,5 Thus, the iron hypothesis should be considered as an important mechanism of protection against CHD in premenopausal women. Correspondence: Dr Mascitelli, 34 Via Manzoni, Tricesimo (UD) 33019, Italy (lumasci@libero.it). References 1. Kannel WBLevy D Menopause, hormones, and cardiovascular vulnerability in women. Arch Intern Med 2004;164479- 481PubMedGoogle ScholarCrossref 2. Sullivan JL Iron and the sex difference in heart disease risk. Lancet 1981;11293- 1294PubMedGoogle ScholarCrossref 3. Triemstra MRosendaal FRSmit CVan der Ploeg HMBriet E Mortality in patients with hemophilia: changes in a Dutch population from 1986 to 1992 and 1973 to 1986. Ann Intern Med 1995;123823- 827PubMedGoogle ScholarCrossref 4. Kiechl SWilleit JEgger GPoewe WOberhollenzer F Body iron stores and the risk of carotid atherosclerosis: prospective results from the Bruneck study. Circulation 1997;963300- 3307PubMedGoogle ScholarCrossref 5. Wolff BVölzke HLüdemann J et al. Association between high serum ferritin levels and carotid atherosclerosis in the study of health in Pomerania (SHIP). Stroke 2004;35453- 457PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Cardiovascular Protection in Premenopausal Women

Cardiovascular Protection in Premenopausal Women

Abstract

Kannel and Levy,1 commenting on the Framingham findings, which showed that natural menopause, surgical menopause with simple hysterectomy, or surgical menopause with hysterectomy and oophorectomy were associated with similar increases in coronary heart disease (CHD), suggested that an intact uterus might have a role in the protection of premenopausal women. A plausible explanation of these findings might be related to the beneficial effect of iron depletion in menstruating women (ie, the iron...
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Publisher
American Medical Association
Copyright
Copyright © 2005 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.165.1.120-a
Publisher site
See Article on Publisher Site

Abstract

Kannel and Levy,1 commenting on the Framingham findings, which showed that natural menopause, surgical menopause with simple hysterectomy, or surgical menopause with hysterectomy and oophorectomy were associated with similar increases in coronary heart disease (CHD), suggested that an intact uterus might have a role in the protection of premenopausal women. A plausible explanation of these findings might be related to the beneficial effect of iron depletion in menstruating women (ie, the iron hypothesis suggested by Sullivan2 in 1981). The decrease of stored tissue iron caused by recurrent bleeding might also explain the reduced risk of fatal ischemic heart disease seen in patients with hemophilia.3 Furthermore, serum ferritin, a good measurement of body iron stores, emerged as one of the strongest risk factors for progression of carotid atherosclerosis.4,5 Thus, the iron hypothesis should be considered as an important mechanism of protection against CHD in premenopausal women. Correspondence: Dr Mascitelli, 34 Via Manzoni, Tricesimo (UD) 33019, Italy (lumasci@libero.it). References 1. Kannel WBLevy D Menopause, hormones, and cardiovascular vulnerability in women. Arch Intern Med 2004;164479- 481PubMedGoogle ScholarCrossref 2. Sullivan JL Iron and the sex difference in heart disease risk. Lancet 1981;11293- 1294PubMedGoogle ScholarCrossref 3. Triemstra MRosendaal FRSmit CVan der Ploeg HMBriet E Mortality in patients with hemophilia: changes in a Dutch population from 1986 to 1992 and 1973 to 1986. Ann Intern Med 1995;123823- 827PubMedGoogle ScholarCrossref 4. Kiechl SWilleit JEgger GPoewe WOberhollenzer F Body iron stores and the risk of carotid atherosclerosis: prospective results from the Bruneck study. Circulation 1997;963300- 3307PubMedGoogle ScholarCrossref 5. Wolff BVölzke HLüdemann J et al. Association between high serum ferritin levels and carotid atherosclerosis in the study of health in Pomerania (SHIP). Stroke 2004;35453- 457PubMedGoogle ScholarCrossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 10, 2005

Keywords: cardiovascular system,premenopause

References