Estrogen: Effects on the cardiovascular tree

Abstract

My objective is to review the current literature with respect to basic science aspects concerning the effects of both endogenous and exogenous sex steroids on the vascular system. For simplification in this complex, burgeoning field, generalizations are made and mechanisms are highlighted. Major landmark studies in the English language over the past 25 years are reviewed. Cardiovascular, endocrinologic, and gynecologic references are targeted. Investigations by leading authorities are emphasized with an intent to bridge clinical significance with in vitro studies, in vivo data (both animal and human), and current epidemiologic information. Study results indicate that atherosclerotic lesions can stabilize, and occlusion can regress. The combined effects of estrogen in preventing atherosclerosis and maintaining arterial tone and integrity indicate that the circulatory system is a major target for estrogen action. A number of direct and indirect effects of estrogen have been shown to be beneficial.