Abstract:

A reduced level of female sex hormones at menopause leads to development of atherosclerotic manifestations as well as to reduction of bone mineral density The total estimation of changes in blood vessels and bone tissue on the basis of comparison of SCORE scale and FRAX® program ir a single two-dimensional coordinate system makes it possible to determine degree of risks of cardiovascular complications and fractures in the near future of each individual patient.

Aim: was to assess risks of cardiovascular complications and fractures in women in the early postmenopausal period based on the data of SCORE scale and FRAX® program.

Materials and methods: research included 25 women in the variable menopause period without a previous cardiovascular disease (CVD) and osteoporosis (OP). A standard clinical examination, laboratory tests of lipid spectrum, determination of pulse wave velocity, doppler ultrasound of main arteries of the head with the definition of the thickness of the intima-media complex (IMC) of common carotid arteries(CCA), dual energy X-ray absorptiometry were carried out, risk calculations on the basis of SCORE scale and FRAX® computer program were studied. Re-examination of 25 patients was carried out not less than 12 months after the cessation of menses.

Results: baseline characteristics: low risk (less than 1%) was observed in 72% of women on SCORE scale, and 100% of women (less than 10%) was observed on FRAX®. An increasing number of risk factors enhances the performance of «early» markers of atherosclerosis (CPV-13,0 + 3,4 m/s; thickness IMA of CCA-0.95+0,11 mm) and statistically significant (p <0,05) decrease of mineral bone density (BMD). In the early stage of menopause, an increase in the total risk of cardiovascular complications and fractures in coming 10 years was observed. So poor performance risk was observed in 64% of women on SCORE scale, and risk of fractures was observed in 96% of patients on FRAX®.

Conclusion: distribution of studied parameters in a two-dimensional table in accordance with results of the SCORE scale and FRAX® program revealed the prevalence of patients with low values. After 12 months, the growth of BMD was noted in the decrease of number of patients (64%) with low risks and the occurrence of women (8%) with moderate risk of fractures and no cardiovascular risk. BMD study in the early postmenopausal period found a slight decrease in BMD in 48% of women, osteopenia - 44%, osteoporosis - 8%. The comparison of results of both methods makes it possible to assess objectively risks of cardiovascular disease and risk of fractures in each individual patient in next 10 years of their lives. 

References

1.     Evropeyskiye rekomendatsii po profilaktike serdechno-sosudistykh zabolevaniy v klinicheskoy praktike. [The European guidelines for prevention of cardiovascular disease in clinical practice]. Rational pharmacotherapy in cardiology. 2008; 4(3):111-128 [ In Russ].

2.     Nikulina N. N., Yakushin S. A., Frumento G. I."Women's health issues and their solutions. Materials of V Russian conference «Sravnitel'nyy analiz smertnosti ot ostrykh form IBS u muzhchin i zhenshchin»[Comparative analysis of mortality from acute forms of CHD in men and women]. Moscow.2011; 13-14 [ In Russ].

3.     Nikulina N. N., Yakushin S. S., Akinina, S. A. Women's health issues and their solutions.Materials of V Russian conference «Analiz urovnya vyyavlyaemosti v prakticheskom zdravoohranenii ostrykh form IBS u zhenshchin (v sravnenii s muzhchinami)»[Analysis of the detection rate in public health practice acute forms of CHD in women (compared to men)]. Moscow. 2011; 14-15 [In Russ].

4.     Kontsevaya A.V., Kalinina, A. M., Pozdnyakov Yu. M.Klinicheskaya i ehkonomicheskaya celesoobraznost' ocenki serdechno-sosudistogo riska na rabochem meste.[Clinical and economical rationales of cardiovascular risk evaluation at workplace]. Rational pharmacotherapy in cardiology. 2009; (3):36-41[In Russ].

5.     Glezer M. G., Tkacheva O. N. Scientific society of specialists on women's health «Rekomendatsii po snizheniyu obshego riska razvitiyazabolevaniy i oslozhneniy u zhenshchin)» [Recommendations for reducing overall risk of development of diseases and complications in women]. M. 2010;48 [In Russ] .

6.     Conroy R.M., Pyorala K., Fitzgerald A.P Estimation of ten-year risk off at al cardiovascular disease in Europe: the SCORE project. Eur.Heart.J. 2003; 24:987-1003.

7.     Assman G., Barter., Bellosta S., et al. Rukovodstvo po profilaktike ishemicheskoy bolezni serdtsa. Mezhdunarodnaya rabochaya gruppa po orofilaktike ishemicheskoy bolezni serdtsa [Guidelines to prevention of coronary heart disease. International working group for prevention of coronary heart disease].  Germany. STADA. Thomson Reuters. 2011; 130.

8.     Skripnikova I. A. Osteoporosis and osteopathy. Abstracts of the IV Russian Congress on osteoporosis «Chto svyazyvaet osteoporoz i serdechno-sosudistyye zabolevaniya, obuslovlennyye aterosklerozom (CCZ-AS)?»[What connects osteoporosis and cardiovascular disease caused by atherosclerosis (CVD-al)?]. Moscow. 2010; (1):66. [In Russ].

9.     Ershova O. B. Kommentarii k prakticheskomu ispol'zovaniyu Rossiyskikh klinicheskikh rekomendaciy po osteoporozu. [Comments to the practical use of the Russian clinical recommendations for osteoporosis]. Osteoporosis and osteopathy. Scientific-practical journal. 2010; (1):34-46 [In Russ].

10.   Skripnikova I. A., Oganov R.G. Osteoporoz i serdechno-sosudistyye zabolevaniya, obuslovlennyye aterosklerozom, u zhenshchin postmenopauzal'nogo perioda: obshchnost' povedencheskikh i social'nykh faktorov riska. [Osteoporosis and cardiovascular diseases caused by atherosclerosis, postmenopausal women: a community behavior al and social risk factors]. Osteoporosis and osteopathy. 2009; (2):5-9 [In Russ].