Oestrogen exerts vasculoprotective effects in different experimental settings through inhibition of vascular smooth muscle cell proliferation, stimulation of nitric oxide production and attenuation of inflammation. Although these oestrogen-evoked beneficial effects have been attributed to oestrogen receptor alpha (ERa), also ER beta (ERb) and the novel ER G protein-coupled receptor 30 (GPR30)/G protein-coupled ER1 probably play significant roles in vascular oestrogen signalling. Oestrogenevoked vasculoprotective effects are well documented in various experimental models, but the underlying mechanisms are still incompletely understood. The age hypothesis represents an interesting and promising model to explain the discrepancy between experimental data showing beneficial vascular effects of oestrogen treatment and the clinical findings on hormone replacement therapy obtained in big epidemiology surveys, where no protective effect from supplementation with oestrogen is observed. Identification of novel ERs expressed also in the vascular system offers exciting opportunities for the future to find and characterize the mechanisms behind oestrogen-evoked beneficial effects in vascular health and disease. Importantly, some vascular effects of pharmacological concentrations of oestrogen are ER-independent, suggesting that oestrogen besides its specific effects through ERa, ERb and GPR30 also affects vascular function via ER-independent mechanisms probably reflecting interaction of the hydrophobic oestrogen molecule with cell membrane properties. In this MiniReview, we focus on the importance of these different vascular ER subtypes in health and disease.
Cardiovascular Disease and OestrogenDespite improved treatment and awareness, cardiovascular disease and its complications like stroke and myocardial infarction remain the leading cause of death and morbidity in the world. With an increasingly older population in both old developed nations and the developing world, the number of patients suffering from cardiovascular disease will probably increase further during the 21st century. The acute symptoms of cardiovascular disease, like transient ischaemic attack, are commonly initiated by embolism or luminal narrowing of the arteries due to excessive growth of vascular smooth muscle cells. This is in turn initiated by high concentrations of lowdensity lipoproteins in the blood accumulating subendothelially and high blood pressure, respectively Oestrogen possesses atheroprotective effects, observed in premenopausal women being less prone to cardiovascular disease than age-matched men [1]. On average, cardiovascular disease starts 10 years later in women than men and before menopause women have several times lower risk than men [2]. This difference disappears quickly after menopause. Because of this, post-menopausal oestrogen supplementation was believed to have vasculoprotective effects [3]. However, the largest study of the effect of oestrogen supplementation in post-menopausal women, the 2002 Women's Health Initiativ...