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. 2024 Oct 15:46:e-rbgo100.
doi: 10.61622/rbgo/2024rbgo100. eCollection 2024.

Brazilian Guideline on Menopausal Cardiovascular Health - 2024

Gláucia Maria Moraes de Oliveira  1 , Maria Cristina Costa de Almeida  2 , Carolina María Artucio Arcelus  3 , Larissa Espíndola  4   5 , Maria Alayde Mendonça Rivera  6 , Agnaldo Lopes da Silva-Filho  7 , Celi Marques-Santos  8   9 , César Eduardo Fernandes  10 , Carlos Japhet da Matta Albuquerque  11   12   13 , Claudia Maria Vilas Freire  7 , Maria Cristina de Oliveira Izar  14 , Maria Elizabeth Navegantes Caetano Costa  15 , Marildes Luiza de Castro  16 , Viviana de Mello Guzzo Lemke  17 , Alexandre Jorge Gomes de Lucena  18 , Andréa Araujo Brandão  19 , Ariane Vieira Scarlatelli Macedo  20 , Carisi Anne Polanczyk  21 , Carla Janice Baister Lantieri  10 , Eliana Petri Nahas  14 , Elizabeth Regina Giunco Alexandre  22 , Erika Maria Gonçalves Campana  19 , Érika Olivier Vilela Bragança  23 , Fernanda Marciano Consolim Colombo  24 , Imara Correia de Queiroz Barbosa  25 , Ivan Romero Rivera  26 , Jaime Kulak  27 , Lidia Ana Zytynski Moura  28 , Luciano de Mello Pompei  10 , Luiz Francisco Cintra Baccaro  29 , Marcia Melo Barbosa  30 , Marcio Alexandre Hipólito Rodrigues  7 , Marco Aurelio Albernaz  31 , Maria Sotera Paniagua de Decoud  32 , Maria Sanali Moura de Oliveira Paiva  33 , Martha Beatriz Sanchez-Zambrano  34 , Milena Dos Santos Barros Campos  35 , Monica Acevedo  36 , Monica Susana Ramirez  37   38 , Olga Ferreira de Souza  39 , Orlando Otávio de Medeiros  40 , Regina Coeli Marques de Carvalho  41   42 , Rogerio Bonassi Machado  43 , Sheyla Cristina Tonheiro Ferro da Silva  44 , Thais de Carvalho Vieira Rodrigues  35   45 , Walkiria Samuel Avila  24 , Lucia Helena Simões da Costa-Paiva  29 , Maria Celeste Osorio Wender  46
Affiliations

Brazilian Guideline on Menopausal Cardiovascular Health - 2024

Gláucia Maria Moraes de Oliveira et al. Rev Bras Ginecol Obstet. .
No abstract available

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Figures

Figure 1.1
Figure 1.1. Structure of the systematic review that guided this guideline on menopause and postmenopause. CVD: cardiovascular disease; DM: diabetes mellitus; MHT: menopausal hormone therapy; SAH: systemic arterial hypertension.
Figure 1.2
Figure 1.2. Nomenclature related to the women’s life cycle used in this guideline.
Figure 2.1
Figure 2.1. STRAW system for classification of the women’s reproductive stages. AMH: antimüllerian hormone; FSH: follicle-stimulating hormone.
Figure 2.2
Figure 2.2. Hypoestrogenism and coronary artery disease (CAD).
Figure 3.1
Figure 3.1. Relation of menopause and traditional cardiovascular risk factors.
Figure 3.2
Figure 3.2. Relation of menopause and emerging cardiovascular risk factors.
Figure 4.1
Figure 4.1. Cardiovascular risk stratification and therapeutic goals for postmenopausal and menopausal women. Adapted from Oliveira et al.13 ABI: ankle-brachial index; CAC: coronary artery calcium score; CAD: coronary artery disease; CCTA: coronary computed tomography angiography; CRD: chronic renal disease; CVR: cardiovascular risk; DM: diabetes mellitus; eGFR: estimated glomerular filtration rate; GRS: global risk score; MIT: medio-intimal thickening; MS: metabolic syndrome; RF: risk factor; REF: risk-enhancing factors; SAH: systemic arterial hypertension.
Figure 4.2
Figure 4.2. Specific characteristics of female ischemic heart disease as compared to the male one. Adapted from Elias-Smale et al.121 ACS: acute coronary syndrome; CAD: coronary artery disease; RF: risk factor.
Figure 4.3
Figure 4.3. Women-specific risk factors for stroke.
Figure 4.4
Figure 4.4. Menopausal cardiovascular changes and risk of heart failure. Adapted from Muka et al.132
Figure 4.5
Figure 4.5. Risk factors for atrial fibrillation in women. MHT: menopausal hormone therapy; SAH: systemic arterial hypertension.
Figure 5.1
Figure 5.1. Estimated trends in the global age-standardized prevalence of dementia (A) and the all-age number of cases of dementia (B). Source: GBD 2019.162
Figure 5.2
Figure 5.2. Decline of cognitive continuum in normal and pathological aging.159
Figure 5.3
Figure 5.3. Overlapping symptoms of thyroid dysfunctions and menopause.
Figure 5.4
Figure 5.4. Menopause and hyperthyroidism: accumulation of risks. AF: atrial fibrillation; CAD: coronary artery disease.
Figure 5.5
Figure 5.5. Correlation between specific, under-recognized, and well-established risk factors of cardiovascular disease (CVD) in women.173
Figure 5.6
Figure 5.6. Bone mass in men versus women. Men have a reduction in bone mass as age advances, while women have a more marked decline related to menopausal transition/menopause.
Figure 7.1
Figure 7.1. Current recommendations for menopausal hormone therapy.
Figure 8.1
Figure 8.1. Major contraindications to menopausal hormone therapy.179,323
Figure 8.2
Figure 8.2. Flowchart for implementing the current recommendations for menopausal hormone therapy.
Figure 9.1
Figure 9.1. Menopausal symptoms with negative impact on professional performance.
Chart 9.1
Chart 9.1. Practical actions about menopause to be adopted in the workplace by employers.
Figure 10.1
Figure 10.1. Interventions to improve menopause-related situations. CV: cardiovascular; CVR: cardiovascular risk; CVRF: cardiovascular risk factors; LA: Latin America; MHT: menopausal hormone therapy; NHT: nonhormone therapy.
Figure 10.2
Figure 10.2. Latin American demographic and menopause data. LA: Latin America; MHT: menopausal hormone therapy.
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