Postmenopausal hormone replacement therapy and atherosclerosis

Ho, Jennifer E.; Mosca, Lori

doi:10.1007/s11883-002-0077-4

Cited by 15 publications

(10 citation statements)

References 100 publications

(81 reference statements)

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“…The increased risk CVD in postmenopausal women is in part because of detrimental changes in plasma lipoproteins and endothelial function. For example, the changes in estrogen levels following menopause can alter vasodilation, cogulation, inflammation, and the vascular injury response, which can have adverse cardiovascular consequences [28,44]. Those changes in the vasculature can also characterise an accelerated deterioration in the structural and functional integrity of the microcirculation, which maintain blood flow, tissue oxygenation and nutrient delivery, all are factors that affect tissue viability and susceptibility in a range of diseases and conditions such as peripheral arterial disease and chronic venous insufficiency [9,39].…”

Section: Introductionmentioning

confidence: 99%

“…Commonly used strategies to reduce the CVD risk in postmenopausal women have relied on enhancing the hormonal functions and increasing estrogen level through hormone replacement therapies, which showed improvement in flow-mediated vasodilation and peripheral vascular function [24,27,28,41,49]. However, the effectiveness of these strategies alone in reducing the CVD has been debated [31].…”

Section: Introductionmentioning

confidence: 99%

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Effects of exercise training and Mediterranean diet on vascular risk reduction in post-menopausal women

Alkhatib

Klonizakis

2014

Clinical Hemorheology and Microcirculation

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This study tested the potential risk-reduction benefits of Mediterranean Diet (MD) and regular exercise training on microvascular activity and cardiorespiratory capacity in postmenopausal women. Fifteen sedentary postmenopausal participants (age = 54.6 ± 3.6) were randomised into either exercise training or exercise combined with following MD for eight-weeks, and were assessed for their cardiorespiratory capacity, and upper-and lower-limb endothelial cutaneous vascular conductance (CVC) test using Laser Doppler Fluximetry (LDF), coupled with measuring endothelium-dependent Acetylcholine Chloride (Ach) and -dependent Sodium Nitropurruside (SNP) vasodilators. Exercise training improved cardiorespiratory capacity as indicated by ventilatory threshold (11.5 ± 2.1 vs. 14.0 ± 3.0 ml·kg −1 ·min −1 , p < 0.05) and improved the microcirculatory perfusion results of CVC for both vasodilators Ach (p < 0.001, d = 0.65) and SNP (p = 0.003, d = 0.53) in the lower-limb and ACh (p = 0.01, d = 0.41) and SNP (p = 0.03, d = 0.48) in the upper-limb, all (p < 0.05). However, combining exercise with MD showed a stronger improvement in Ach (p = 0.02, d = 0.36) of the lower limb, than in exercise alone group. The results suggest that regular moderate exercise improves microcirculatory vascular function and increases exercise tolerance, both are responsible for reducing cardiovascular risk in postmenopausal women. However, combining MD with exercise suggests additional microvascular vasodialiatory improvement, suggesting an effective strategy for further cardiovascular risk-reduction in this high-risk group.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of exercise training and Mediterranean diet on vascular risk reduction in post-menopausal women

Alkhatib

Klonizakis

2014

Clinical Hemorheology and Microcirculation

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“…In addition, the frequency of cardiovascular disease rises in post-menopausal and in estrogen-deficient women [25]. Because LDL becomes more toxic as its electronegativity increases [16], we hypothesized that LDL electronegativity is higher in male patients with MetS than in female patients with MetS and may underlie the increased propensity to CAD observed in men.…”

Section: Introductionmentioning

confidence: 99%

Gender disparity in LDL-induced cardiovascular damage and the protective role of estrogens against electronegative LDL

Lee

Chen

Chan

et al. 2014

Cardiovasc Diabetol

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BackgroundIncreased levels of the most electronegative type of LDL, L5, have been observed in the plasma of patients with metabolic syndrome (MetS) and ST-segment elevation myocardial infarction and can induce endothelial dysfunction. Because men have a higher predisposition to developing coronary artery disease than do premenopausal women, we hypothesized that LDL electronegativity is increased in men and promotes endothelial damage.MethodsL5 levels were compared between middle-aged men and age-matched, premenopausal women with or without MetS. We further studied the effects of gender-influenced LDL electronegativity on aortic cellular senescence and DNA damage in leptin receptor–deficient (db/db) mice by using senescence-associated–β-galactosidase and γH2AX staining, respectively. We also studied the protective effects of 17β-estradiol and genistein against electronegative LDL–induced senescence in cultured bovine aortic endothelial cells (BAECs).ResultsL5 levels were higher in MetS patients than in healthy subjects (P < 0.001), particularly in men (P = 0.001). LDL isolated from male db/db mice was more electronegative than that from male or female wild-type mice. In addition, LDL from male db/db mice contained abundantly more apolipoprotein CIII and induced more BAEC senescence than did female db/db or wild-type LDL. In the aortas of db/db mice but not wild-type mice, we observed cellular senescence and DNA damage, and the effect was more significant in male than in female db/db mice. Pretreatment with 17β-estradiol or genistein inhibited BAEC senescence induced by male or female db/db LDL and downregulated the expression of lectin-like oxidized LDL receptor-1 and tumor necrosis factor-alpha protein.ConclusionThe gender dichotomy of LDL-induced cardiovascular damage may underlie the increased propensity to coronary artery disease in men.

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“…Östrogene üben sowohl systemische als auch direkte Effekte [8] auf das kardiovaskuläre System aus (Tabelle 1). Unter direkter Wirkung der Östrogene zeigt sich eine Vasodilatation, wobei diese einerseits durch den NOAnstieg, andererseits durch Abnahme der AT 1 -Rezeptoren der glatten Gefäßmuskulatur sowie eine verminderte ACE-Aktivierung vermittelt wird.…”

Section: Positive Und Negative öStrogeneffekte -Eine üBersichtunclassified

Primär- und Sekundärprävention kardiovaskulärer Ereignisse durch Hormonreplacement-Therapie

Pilz

2005

Wien Med Wochenschr

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A recently (2002) published, randomised, double blind placebo controlled trial of hormone replace ment therapy (HRT), the Women's Health Initiative (WHI), is not consistent with the decrease in cardiovascular disease under CEE/HPA seen in observational primary prevention studies like the Nurses' Health Study. Baseline characteristics of participants like age, body mass index, years since menopause and preexistent cardiovascular diseases may be responsible for the lack of benefit seen in this trial. Clinical outcome data of HRT from randomised trials in secondary prevention of cardiovasular diseases are limited. The first prospective, randomised placebo controlled trial, the Heart and Estrogen/Progestin Replacement Study (HERS) in secondary prevention did not show any difference in CHD events between treatment groups and placebo during a follow up of 4.1 years. However, an increased risk of CHD was seen especially during the first year on HRT, subsequent years showed a decrease in event rate compared with never-users. One explanation for this lack of benefit may be a bi-directional effect of estrogen - early risk and late benefit - especially in an elderly study population with established atherosclerotic lesions. In postmenopausal women, estrogen replacement therapy affects LDL- and HDL-cholesterol levels favorably, causes vasodilatation by activating NOS, inhibits platelet aggregation and proinflammatory cell adhesion on endothelial cells of vascular wall. Estrogen can affect the cardiovascular system adversely by increasing triglycerid levels, CPR and proinflammatory cytokines like tumor necrosis factor alpha (TNF-alpha). Alternatives to HRT like phytoestrogens act via estrogen alpha and beta receptor modulation. Phytoestrogens may lower LDL-cholesterol levels without increasing triglyceride levels, they have shown antioxidannt properties as well as favorable effects on vascular reactivity. The importance of HRT and phytoestrogens in primary and secondary prevention of cardiovascular disease remains to be established.

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Postmenopausal hormone replacement therapy and atherosclerosis

Cited by 15 publications

References 100 publications

Effects of exercise training and Mediterranean diet on vascular risk reduction in post-menopausal women

Effects of exercise training and Mediterranean diet on vascular risk reduction in post-menopausal women

Gender disparity in LDL-induced cardiovascular damage and the protective role of estrogens against electronegative LDL

Primär- und Sekundärprävention kardiovaskulärer Ereignisse durch Hormonreplacement-Therapie

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