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Edited by Catherine D. DeAngelis, MD, MPH, and Margaret A. Winker, MD
Physical Activity and Coronary Heart Disease in Women
Physically active women have lower rates of coronary heart disease than
inactive women. To determine whether this association differs by intensity
of activity or for women at high risk of coronary heart disease, Lee and colleagues
analyzed data from 39 372 healthy women enrolled in the Women's Health
Study and followed up for an average of 5 years. Physical activity, even light
to moderate activity, was inversely associated with risk of coronary heart
disease, including among women who were overweight, had increased cholesterol
levels, or were smokers.
Homicide as a Cause of Pregnancy-Associated Death
Using a definition of pregnancy-associated death as a death during pregnancy
or within 1 year of delivery or pregnancy termination from any cause, including
injuries, suicide, or homicide, Horon and ChengArticle used multiple data sources
to identify pregnancy-associated deaths in Maryland between 1993 and 1998.
The leading cause of pregnancy-associated death was homicide, followed by
cardiovascular disorders. In an editorial, FryeArticle urges routine screening of
all female patients for domestic violence.
Estrogen After Menopause
The decision to use hormone replacement therapy (HRT) after menopause
is complicated by conflicting data on its benefits, such as reducing risk
of dementia, and the increase in risk of endometrial and breast cancer, and
possibly ovarian cancer. In a prospective study of postmenopausal women followed
up for 14 years, Rodriguez and colleaguesArticle found that women who used estrogens
at baseline (1982) or within 15 years prior to baseline for 10 or more years
had higher death rates from ovarian cancer than never users. Geerlings and
colleaguesArticle, using data from a prospective study of postmenopausal women aged
55 or older, found that a longer reproductive period, as an indicator of long-term
exposure to endogenous estrogens, was not associated with a decreased risk
of dementia. LeBlanc and colleaguesArticle conducted a systematic review and meta-analysis
of studies on the relationship between HRT and the risk of cognitive decline
and dementia. HRT use was associated with improvement in some cognitive functions
among women who had symptoms of menopause, but not among asymptomatic women.
Risk of dementia appeared to be reduced among women who used HRT, but most
of the studies had methodological limitations.
Mortality Among Women With HIV and Depression
Clinical levels of depression have been reported by 30% to 60% of women
infected with HIV. Ickovics and colleagues used data from the prospective
HIV Epidemiologic Research Study to determine whether depressive symptoms
were associated with HIV-related mortality among women infected with HIV observed
for up to 7 years. HIV-seropositive women with chronic depressive symptoms
were 2 times more likely to die than those with limited or no depressive symptoms.
Chronic depressive symptoms were also associated with significantly greater
decline in CD4 cell counts.
Ipriflavone as Therapy for Postmenopausal Osteoporosis
In preclinical studies, ipriflavone, a synthetic isoflavone derivative
available as an over-the-counter preparation, has been shown to inhibit bone
resorption and stimulate osteoblast activity. In this randomized trial among
postmenopausal women, Alexandersen and colleagues found that during the 3-year
treatment period, decreases in bone mineral density were not significantly
different between the ipriflavone and placebo groups, and changes in biochemical
markers of bone resorption and rates of new vertebral fracture were also similar.
Twenty-nine of the 234 women in the ipriflavone group developed subclinical
lymphocytopenia during ipriflavone treatment, most of whom recovered spontaneously
within 2 years after discontinuation of ipriflavone.
A Piece of My Mind
"When I was told my diagnosis, my first question was: ‘How will
I tell my sisters?'" From "Searching for Margaret."
Available therapies for postmenopausal osteoporosis and the patient
subgroups likely to benefit.
Medical News & Perspectives
Physicians who treat women are putting increased emphasis on encouraging
physical exercise to enhance female strength and agility and on effectively
Cervical Cytologic and Histologic Diagnoses
Findings that agreement among well-trained pathologists on the interpretation
of cytologic and histologic cervical specimens is only moderate, and not more
reproducible for histologic than for cytologic specimens, underscore the need
to clarify diagnostic criteria and nomenclature.
JAMA Patient Page
For your patients: Information about the benefits of physical activity
and exercise for women's cardiovascular health.
This Week in JAMA . JAMA. 2001;285(11):1399. doi:10.1001/jama.285.11.1399
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