Estrogen Replacement Therapy/adverse effects

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Editorial

Overcoming Women’s Lifelong Hormonal Rollercoaster: A Turning Point for Cardiovascular Prevention

Although cardiovascular diseases (CVD), especially coronary artery disease and stroke, are the leading cause of death and disability in Brazil, both in women and men,^, addressing cardiovascular (CV) prevention implies a comprehensive approach to the inherent differences related to sex. In this sense, understanding, for instance, the role of hypertension, a major risk factor for coronary artery disease and stroke in Brazilian women, in the context of this population’s specificities is key.

Hypertensive disorders, including pregnancy-induced hypertension (occurring in 6-7% of pregnancies) and preeclampsia/eclampsia (occurring in up to 10% of pregnancies), are important CV risk factors^, that should be accounted for when assessing women’s CV risk.

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Original Article

Changes in Cardiac Autonomic Modulation in Women with Breast Cancer Using Aromatase Inhibitors and the Relation with Biochemical Variables

Luana Almeida Gonzaga et al. Thais Reis Silva de Paulo Juliana Viezel Laís Manata Vanzella … Ismael Forte Freitas Jr. Luiz Carlos Marques Vanderlei

Abstract

Background:

The use of autonomic modulation as a predictor of cardiovascular risk in women with breast cancer is important.

Objective:

To evaluate the cardiac autonomic modulation of postmenopausal women using aromatase inhibitors for breast cancer treatment, as well as its relation with the following biochemical variables.

Methods:

Postmenopausal women who did not have breast cancer (n = 33) and postmenopausal women with breast cancer (n = 15). For evaluation of the autonomic modulation the heart rate was recorded beat-to-beat for 30 minutes and the series of RR intervals obtained were used to calculate the following heart rate variability indices: Mean RR ms, SDNN (standard deviation of all normal RR intervals, expressed in milliseconds) ms, Mean HR, RMSSD (square root of the mean of the squared differences between adjacent normal RR interval) ms, NN50 (number of pairs of successive NNs that differ by more than 50 ms) count, pNN50% (proportion of NN50 divided by total number of NNs), RRtri (RR triangular), TINN (triangular interpolation of NN interval) ms, SD1 ms, SD2 ms, LF ms², HF ms², LH/HF ms². The values of biochemical variables (fasting glycemia, triglycerides, HDL-cholesterol, and C-reactive protein) were analyzed by blood sample.

Results:

Lower values of heart rate variability indices were observed in postmenopausal women with breast cancer in relation to postmenopausal women who did not have breast cancer: Mean RR (p = 0.03); SDNN (p = 0.03); RMSSD (p = 0.03); NN50 count (p = 0.03); pNN50 % (p = 0.03); RRtri (p = 0.02); SD1 (p = 0.01); SD2 (p = 0.02); LF ms² (p = 0.01); HF ms² (p = 0.03).There was an inversely proportional correlation between the indices SDNN, SD2, and HFms² with triglycerides (SDNN p = 0.04; SD2 p = 0.04; HF ms² p = 0.04). No statistically significant correlations were found between heart rate variability indices and others variables. Statistical significance was set at 5% for all analyses.

Conclusion:

Women with breast cancer present reduced autonomic modulation and in these women of heart rate variability indices are inversely correlated with triglyceride values.