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Sci. Aging Knowl. Environ., 21 December 2005 REVIEWSHarnessing Hormonal Signaling for CardioprotectionVictoria L. Ballard, and Jay M. Edelberg The authors are at the Department of Medicine and Department of Cell and Developmental Biology at Weill Medical College of Cornell University, New York, NY, 10021, USA. E-mail: jme2002{at}med.cornell.edu (J.M.E.) http://sageke.sciencemag.org/cgi/content/full/2005/51/re6Key Words: estrogen cardiovascular disease menopause hormone replacement therapy selective estrogen receptor modulators
Abstract: Cardiovascular disease is the leading cause of death in women in the Western world and is predominant among the elderly. A large body of evidence suggests that hormonal signaling plays a critical role in the regulation of cardioprotective mechanisms, as premenopausal women are at significantly lower risk of heart disease compared with men, but the risk greatly increases with the onset of menopause. This association indicates that estrogen may protect the heart from cardiovascular disease. Whereas a number of analyses of the effects of hormone replacement therapy (HRT) on postmenopausal women supported the idea that estrogen is a cardioprotective factor, the findings of the more recent Women's Health Initiative (WHI) study suggested that HRT may actually increase the risk of cardiovascular events. These conflicting reports have left both patients and clinicians reluctant to continue using current HRT regimes. The WHI findings do not, however, negate the epidemiological link between menopause and increased cardiovascular risk. Hence, the identification of the specific actions of estrogen that promote cardioprotective pathways without enhancing deleterious vascular mechanisms may provide novel estrogen-based alternatives to current HRT strategies. In this Review, we outline the known actions of estrogen on the cardiovascular system, focusing on cardioprotective mechanisms that may be targeted for the development of new therapeutic approaches. Citation: V. L. Ballard, J. M. Edelberg, Harnessing Hormonal Signaling for Cardioprotection. Sci. Aging Knowl. Environ. 2005 (51), re6 (2005).
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Science of Aging Knowledge Environment. ISSN 1539-6150