Metabolic and vascular effect of progestins in post-menopausal women. Implications for cardioprotection.
Estrogen therapy causes changes in a variety of cardiovascular risk factors, including insulin resistance, lipoprotein profile, haemostasis, coronary atherosclerosis and vascular reactive, that suggest a potential cardioprotective effect in postmenopausal women. With respect to the role of adjunctive progestins, currently available data suggest that the cardiovascular effects may differ depending on the type, dosage and route of administration of the progestin. Androgenic progestins antagonise the favourable cardiovascular effect of estrogens, whilst non-androgenic progestins do not impair, or may even enhance, the beneficial effect of estrogens. Therefore, less androgenic progestins would appear to be the agent of choice for combined hormone therapy in postmenopausal women with cardiovascular risk factors.
Rosano
Giuseppe M C
GM
Cardiovascular Research Unit, Department of Internal Medicine, San Raffaele, Tosinvest Sanita', Via della Pisana 235, 00168 Rome, Italy. rosanog@yahoo.com
Vitale
Cristiana
C
Silvestri
Antonello
A
Fini
Massimo
M
D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002637:Chest Pain / Q000517:prevention & control; D003324:Coronary Artery Disease / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000378:metabolism; D004730:Endothelium, Vascular / Q000187:drug effects; D004967:Estrogens / Q000494:pharmacology; D005260:Female; D006487:Hemostasis; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D017202:Myocardial Ischemia / Q000517:prevention & control; D017698:Postmenopause / Q000378:metabolism*; D011372:Progestins / Q000378:metabolism* / Q000494:pharmacology*; D014664:Vasodilation / Q000187:drug effects
D004967:Estrogens; D008055:Lipids; D011372:Progestins