Estrogen Status Correlates with the Calcium Content of Coronary Atherosclerotic Plaques in Women

Abstract

Estrogen status is associated with coronary calcium and plaque area independent of age and CHD risk factors. Estrogen may modulate the calcium content of atherosclerotic plaques, as well as plaque area and may slow the progression of atherosclerosis in women.

Differential effects of 17β-estradiol and raloxifene on VSMC phenotype and expression of osteoblast-associated proteins

“…Medium was changed every 3 days. Cells were collected on days 0, 1,2,3,6,9,12, and 15 for determination of calcium content and protein expression.…”

“…The idea that osteoblast-specific genes could link osteoporosis and arterial calcification is supported indirectly by the high clinical prevalence of arterial calcification and cardiovascular disease in postmenopausal women with osteoporosis (19,27,48). An estrogen-replete condition correlated with decreased incidence of coronary arterial calcification in women (12,52). However, it is not known whether reduced arterial calcification results from effects of estrogen on bone-like characteristics within populations of VSMCs (3,18).…”

Vascular Calcification

“…However, this view was reversed once randomized controlled trials were performed in large numbers, pointing to the hazard of reliance on observational studies, 102,103 and opening the possibility that vascular calcification contributes to adverse effects. Some clinical studies now confirm higher calcium content in coronary plaques of women using hormone replacement therapy (HRT), 104,105 whereas other observational studies report reduction in coronary calcification with HRT. 106 Conclusions about the relationship between estrogen and coronary calcification cannot be reliably determined from observational studies.…”

Detection of carotid artery calcification on the panoramic images of post-menopausal females is significantly associated with severe abdominal aortic calcification: a risk indicator of future adverse vascular events

“…22 The development of these lesions in post-menopausal females is believed to arise in part from a paucity of oestrogen, weight gain, systemic hypertension and serum lipid abnormalities. 23 Locally, the transdifferentiation of vascular smooth muscle cells into osteoblastic-like cells contributes to the development of vascular calcifications. 24 Given that atherosclerosis is a systemic disorder, it occurs throughout the arterial tree.…”