Effects of estrogens on lipoprotein metabolism and cardiovascular disease in women.

Abstract:

:Estrogen use is associated with protection from cardiovascular disease in postmenopausal women. This benefit appears to be magnified among women with pre-existing heart disease. The possible bias of intrinsically better health in women using estrogen has not been ruled out in observational studies. Therefore, two double-blind randomized clinical trials are underway in postmenopausal women. One in women with coronary disease is known as HERS (Heart Estrogen-progestin Replacement Study) and another in predominantly healthy women is the WHI (Women's Health Initiative). Several mechanisms of estrogen mediated protection from cardiovascular disease have been identified including increased HDL, lower LDL, lower VLDL-cholesterol/triglyceride ratio, increased clearance of intermediate density lipoprotein (IDL) and LDL via an upregulated LDL receptor, diminished penetration and degradation of LDL in the arterial wall, an inhibition of LDL oxidation by various estrogens and a reversal of inappropriate acetylcholine (EDRF)-mediated vasoconstriction in arteriosclerotic vessels. The predominating mechanism is not known, but estrogen replacement therapy is both likely to be beneficial to female health, pending randomized trials, as well as a tool to understand mechanisms of prevention of coronary artery disease.

journal_name

Atherosclerosis

journal_title

Atherosclerosis

authors

Knopp RH,Zhu X,Bonet B

doi

10.1016/0021-9150(94)05379-w

subject

Has Abstract

pub_date

1994-10-01 00:00:00

pages

S83-91

eissn

0021-9150

issn

1879-1484

pii

0021-9150(94)05379-W

journal_volume

110 Suppl

pub_type

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