Cardiovascular Diseases in Women: An Equal Opportunity Killer

Morgan, Nancy A.; Colling, Cindy; Fye, Carol L.

doi:10.1016/s1086-5802(16)30075-4

Cited by 4 publications

(3 citation statements)

References 83 publications

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“…17β-estradiol is known to provide a protective effect on the cardiovascular system [13]. A study reported that about a 50% reduction in cardiovascular events in women receiving postmenopausal hormone replacement therapy, when compared with untreated women [28]. A previous study has indicated that women receiving hormone replacement therapy presented a reduction of the left ventricular mass and left ventricular dimensions when compared with women without hormone replacement therapy [29].…”

Section: Discussionmentioning

confidence: 99%

Combined effects of 17β-estradiol and exercise training on cardiac apoptosis in ovariectomized rats

Lin

Chen

et al. 2018

PLoS ONE

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BackgroundThe purpose of this study was to investigate the combined 17β-estradiol (E2) and exercise training on cardiac pro-survival and anti-apoptotic pathways in ovariectomized rats.MethodsFifty-six female Sprague–Dawley rats were divided into a sham-operated (Sham), a bilaterally ovariectomized (OVX), an OVX treated with E2 (OVX-E2; 10μg/kg/day), and an OVX with E2 and treadmill exercise training (OVX-E2-EX; 60 min/day, 5 days/week) for 10 weeks. Following 10 weeks of exercise training, rat hearts were isolated for the evaluation of Histopathological analysis, TUNEL assay, and Western blotting.ResultsThe protein levels of estrogen receptor α (ERα), estrogen receptor β (ERβ), insulin-like growth factor 1 (IGF-1), IGF-1 receptor (IGF-1R), phospho-phosphatidylinositol 3-kinase (p-PI3K) (estrogen receptors/IGF-1-related survival pathway) were significantly increased in either the OVX-E2 or OVX-E2-EX group when compared with the OVX group. The protein levels of B-cell lymphoma 2 (Bcl-2), B-cell lymphoma-extra-large (Bcl-xL) and phosphorylated-Bad (p-Bad) (Bcl-2 family survival pathway) were significantly increased in the OVX-E2-EX group when compared with the OVX group. Only the p-Bad was significantly increased in the OVX-E2 group when compared with the OVX group. The protein levels of truncation of Bid (t-Bid), Bcl-2-associated death promotor (Bad), Bcl-2-associated X protein (Bax), Cytochrome c, caspases-9, and caspases-3 (mitochondria-dependent apoptotic pathway), as well as the protein levels of tumor necrosis factor-α (TNF-α), Fas ligand, Fas receptors, Fas-associated death domain (FADD), activated caspase-8 and activated caspase-3 (Fas receptor–dependent apoptotic pathway) were significantly decreased in either the OVX-E2 or OVX-E2-EX group when compared with the OVX group. Furthermore, when compared with the OVX-E2 group, the protein levels of ERβ, IGF-1, IGF-1R, Bcl-2 and Bcl-xL were further enhanced in the OVX-E2-EX group as well as the protein levels of Cytochrome c, Fas receptors, FADD, activated caspase-8, activated caspase-9 and activated caspase-3 were further decreased in the OVX-EX-E2 group.ConclusionsCombined E2 and exercise training exhibited a positive effect of protection on ovariectomy-induced cardiac apoptosis by enhancing ERβ-related survival pathways, which might provide a more effective therapeutic effect on cardiac protection in bilaterally oophorectomized or menopausal women than E2 treatment only.

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Section: Discussionmentioning

confidence: 99%

Combined effects of 17β-estradiol and exercise training on cardiac apoptosis in ovariectomized rats

Lin

Chen

et al. 2018

PLoS ONE

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“…Estrogen replacement was thought to reduce CVD risk in postmenopausal women [13]. Early cross-sectional studies suggested a 50 % lower risk of heart disease in post-menopausal women with estrogen replacement compared to non-users [32]. Meta analysis revealed a range of 25 % -44 % reduction in CVD risk with post-menopausal hormone replacement therapy (HRT) depending on HRT formula and intervening factors such as cigarette smoking [7].…”

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confidence: 99%

Combination of Estrogen Replacement and Exercise Protects Against HDL Oxidation in Post-Menopausal Women

Lawler

Green

et al. 2002

Int J Sports Med

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The incidence of atherosclerosis and cardiovascular disease (CVD) in women increases following menopause and has been associated with a reduction in circulating estrogen. Increased CVD risk is also perpetuated by sedentary lifestyle. Growing evidence indicates that oxidation of lipoproteins leads to a powerful immune response, disruption of normal lipoprotein function, and deposition of atherosclerotic plaques. For example, once high-density lipoproteins (HDL) are oxidized, they lose the ability to a) participate in reverse transport of cholesterol to the liver, and b) protect low-density lipoproteins (LDL) against oxidation. The purpose of this study was to determine the effects of combining estrogen replacement and exercise upon lipid peroxidation of the HDL fraction (HDL-ox). Blood samples were drawn from 34 post-menopausal women from four groups: women who were not receiving estrogen replacement and who were sedentary (NSD) (n = 9); women who were not receiving estrogen replacement and who were participating in regular exercise (NEX) (n = 8); women who were receiving estrogen replacement and who were sedentary (ESD) (n = 8); and women who were receiving estrogen replacement and who were participating in regular exercise (EEX) (n = 9). Total-HDL cholesterol was significantly higher (p<0.05) in EEX when compared with NEX, NSD, and ESD. HDL-ox was assessed via malondialdehyde (MDA). Mean (+/- SEM) values for HDL MDA expressed in nM are as follows: NSD = 903.3 +/- 118.4; NEX = 1226.7 +/- 247.7; ESD = 876.7 +/- 116.3; EEX = 537.4 +/- 74.8. EEX lipid peroxidation was significantly (p = 0.02) lower than NEX. Lipid peroxidation tended to be lower in EEX than in NSD and ESD (p = 0.07). These data indicate that the combination of estrogen replacement and regular exercise in post-menopausal women may be most effective in reducing oxidation of HDL in vivo.

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“…This is consistent with previously observed sex differences (12,13). Also, more women develop diabetes complications when compared with men and are at a greater disadvantage than men once they develop diabetes (14)(15)(16)(17).…”

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confidence: 99%

The Effect of Diabetes and Sex on Nitric Oxide–Mediated Cardiovascular Dynamics

Martínez‐Nieves

Dunbar

2001

Exp Biol Med (Maywood)

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Diabetes is associated with impaired cardiovascular responses that are especially prominent in females. Since nitric oxide (NO)mediated effects on cardiovascular dynamics are altered in diabetes, we evaluated the effect of L-NAME, a nitric oxide synthase (NOS) antagonist, on mean arterial pressure (MAP), heart rate (HR), and selective vascular flows in both male and female normal and diabetic rats as an Index of NO activity. Rats were made diabetic using streptozotocin and maintained for 5-6 weeks. Following anesthesia with urethane/a-chloralose, the femoral artery and vein were cannulated for recording and sampling, and flow probes were placed on the iliac, renal, and superior mesenteric arteries. A bolus infusion of L-NAME (10mgl kg) resulted in a rapid +52% and +68% increase In MAP in normal female and male rats, respectively. However, diabetic females' and males' responses were significantly lower (44% and 45%, respectively) when compared with their normal counterparts. The decreased HR in response to the peak pressor effect of L-NAME was more prominent in normal females compared with normal males (-14% vs 2%). The results in diabetic females and males were equivalent (-6% vs-9%, respectively). L-NAME decreased the conductance (flowIMAP) an average of 65% In all three vascular beds in normal female rats. In diabetic females, the iliac and superior mesenteric responses to L• NAME were less, and the renal conductance was contrastlngly Increased 23%. The response to L-NAME was comparable (-62%) in the renal and superior mesenteric and less (-40%) in the iliacs of normal versus diabetic males. We concluded that diabetes is associated with a decreased pressor response to NOS inhibition. And the Impaired constriction response of the renal vessels noted in female diabetic rats may provide a basis for the Increased renal pathology observed in diabetic humans.

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Cardiovascular Diseases in Women: An Equal Opportunity Killer

Cited by 4 publications

References 83 publications

Combined effects of 17β-estradiol and exercise training on cardiac apoptosis in ovariectomized rats

Combined effects of 17β-estradiol and exercise training on cardiac apoptosis in ovariectomized rats

Combination of Estrogen Replacement and Exercise Protects Against HDL Oxidation in Post-Menopausal Women

The Effect of Diabetes and Sex on Nitric Oxide–Mediated Cardiovascular Dynamics

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