Re: blood pressure - plaque relation

On Oct 10, 7:24 am, "Andrew B. Chung, MD/PhD"

I don't know if you've heard of aromatase inhibitors, but that's what
they are going to switch me to after 5 years of tamoxifen. Aromatase
inhibitors lower your risk of recurrence more than tamoxifen, but they
do it by really getting your estrogen down to negligible levels. That
has got to have a cardiovascular effect.

Would be wary of that which is not tried and true.

There was one trial comparing an AI with tamoxifen where there were
more cardiac events in the women on the AI. They really don't know
the long term effects yet.

Most would consider a cardiac event to be an end point.

End points are essentially long term effects.


Technically, the endpoints in such a trial would be "disease-free
survival" and that kind of thing (i.e., related to whether or not the
breast cancer recurs). Cardiac events would be adverse events. They
start reporting results in these trials very early, because there are
a lot of "events" i.e., women dying or relapsing. When I said long
term, I meant over periods of say 10-20 years. Even if over 3 years
or 5 years there aren't excess cardiovascular events, that doesn't
mean there is no adverse effect. There could be an increase in
subclinical atherosclerosis due to the low estrogen levels that would
lead to cardiac events over the long term.

Marilyn

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