Gefassprotektion durch Ostrogene. Wirkungen in vitro und in vivo - Mechanismen und klinische Implikationen

Translated title of the contribution: Vascular protection with estrogens. In vivo and in vitro effects - Mechanisms and clinical implication

M. Barton, E. Wright, D. Do, Z. Yang, E. Espinosa, U. Arnet, T. F. Luscher

Research output: Contribution to journalArticle

Abstract

Myocardial infarction is the major cause of death in the western world. Men are more prone to develop coronary artery disease than women of the same age, in whom coronary disease is rare before menopause. Epidemiological data have shown that estrogens are vasoprotective especially in the coronary circulation - but the underlying mechanisms have been investigated more thoroughly only in recent years. Only up to half of the protective effect of estrogen replacement therapy can be attributed to its positive effects of the lipid profile. However, a large part of this protection is caused by mechanisms distinct from lipid metabolism. It is now known that estrogens also exert effects on vascular function and structure of the vessel wall involving numerous cellular and molecular mechanisms. Actions of natural estrogens on human vascular cells and arteries will be discussed. Estrogens modulate vascular function by increasing nitric oxide production via stimulation of endothelial nitric oxide synthase (eNOS) and decreasing endothelin-1 levels in vivo. Furthermore, 17-β estradiol is a potent inhibitor of vascular smooth muscle cell proliferation and migration, which play a major role in atherosclerotic vascular disease and in the remodelling process. 17-β estradiol also acutely affects vascular tone in human arteries and attenuates constriction induced by contractile agonists. Finally, clinical studies showed that 17-β estradiol can acutely and chronically ameliorate vascular function in women with and without vascular disease. In conclusion, results from clinical and in vitro studies showed positive effects of natural estrogens on vascular function which could explain in part their protective actions against coronary heart disease. Thus, primary prevention of coronary heart disease by estrogen replacement therapy after menopause appears to be a new approach to reduce cardiovascular mortality in women.

Translated title of the contributionVascular protection with estrogens. In vivo and in vitro effects - Mechanisms and clinical implication
Original languageGerman
Pages (from-to)129-137
Number of pages9
JournalPraxis
Volume86
Issue number5
Publication statusPublished - 1997

Keywords

  • coronary heart disease
  • endothelium
  • estrogens
  • menopause
  • prevention

ASJC Scopus subject areas

  • Medicine(all)

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    Barton, M., Wright, E., Do, D., Yang, Z., Espinosa, E., Arnet, U., & Luscher, T. F. (1997). Gefassprotektion durch Ostrogene. Wirkungen in vitro und in vivo - Mechanismen und klinische Implikationen. Praxis, 86(5), 129-137.