Need for research on estrogen receptor function: importance for postmenopausal hormone therapy and atherosclerosis.
BACKGROUND
Cardiovascular disease is the leading cause of morbidity and mortality in men and women worldwide. Although rare in premenopausal women, its incidence rises sharply after menopause, indicating atheroprotective effects of endogenous estrogens.


OBJECTIVE
This review discusses the differential effects of estrogen receptor function on atherosclerosis progression in pre- and postmenopausal women, including aspects of gender differences in vascular physiology of estrogens and androgens.


METHODS
Recent advances in the understanding of the pathogenesis of atherosclerosis, estrogen receptor function, and hormone therapy are reviewed, with particular emphasis on clinical and molecular issues.


RESULTS
Whether hormone therapy can improve cardiovascular health in postmenopausal women remains controversial. Current evidence suggests that the vascular effects of estrogen are affected by the stage of reproductive life, the time since menopause, and the extent of subclinical atherosclerosis. The mechanisms of vascular responsiveness to sex steroids during different stages of atherosclerosis development remain poorly understood in women and men.


CONCLUSIONS
In view of the expected increase in the prevalence of atherosclerotic vascular disease worldwide due to population aging, research is needed to determine the vascular mechanism of endogenous and exogenous sex steroids in patients with atherosclerosis. Such research may help to define new strategies to improve cardiovascular health in women and possibly also in men.
Meyer
Matthias R
MR
Departement für Innere Medizin, Molekulare Innere Medizin, Klinik und Poliklinik für Innere Medizin, UniversitätsSpital, Zürich, Switzerland.
Haas
Elvira
E
Barton
Matthias
M
D000818:Animals; D050197:Atherosclerosis / Q000503:physiopathology*; D035843:Biomedical Research; D002986:Clinical Trials as Topic; D018450:Disease Progression; D004958:Estradiol / Q000031:analogs & derivatives; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000097:blood / Q000502:physiology*; D006801:Humans; D008019:Life Style; D008593:Menopause / Q000502:physiology*; D011960:Receptors, Estrogen / Q000502:physiology*; D012106:Research; D018570:Risk Assessment
D004967:Estrogens; D011960:Receptors, Estrogen; D004958:Estradiol