Abstract
Decreased plasma oestrogen concentrations associated with the menopause appear to be a risk factor for coronary heart disease in women. Oestrogen replacement therapy has beneficial effects on plasma lipids, haemostatic factors, and peripheral and coronary arterial reactivity, suggesting a possible therapeutic effect of oestrogen therapy. Acute 1 Gilligan DM Quyyumi AA Cannon III, RO Effects of physiological levels of oestrogen on coronary vasomotor function in postmenopausal women. Circulation. 1994; 89: 2545-2551 Crossref PubMed Scopus (513) Google Scholar , 2 Collins P Rosano GMC Sarrel PM et al. Estradiol-17β attenuates acetylcholine-induced coronary arterial constriction in women but not men with coronary heart disease. Circulation. 1995; 92: 24-30 Crossref PubMed Scopus (478) Google Scholar and chronic 3 Herrington DM Braden GA Williams JK Morgan TM Endothelial-dependent coronary vasomotor responsiveness in postmenopausal women with and without estrogen replacement therapy. Am J Cardiol. 1994; 73: 951-952 Summary Full Text PDF PubMed Scopus (181) Google Scholar oestrogen administration attenuates or reverses acetylcholine-induced coronary-artery vasoconstriction at physiological concentrations. Acute oestrogen administration favourably affects pacing-induced and exercise-induced myocardial ischaemia in postmenopausal women with coronary artery disease 4 Rosano GMC Caixeta AM Chierchia SL et al. Acute anti-ischemic effect of estradiol-17β in postmenopausal women with coronary heart disease. Circulation. 1997; 96: 2837-2841 Crossref PubMed Scopus (43) Google Scholar , 5 Rosano GMC Sarrel PM Poole-Wilson PA Collins P Beneficial effect of oestrogen on exercise-induced myocardial ischaemia in women with coronary heart disease. Lancet. 1993; 342: 133-136 Summary PubMed Scopus (422) Google Scholar . However the efficacy of long-term oestrogen therapy on the treatment of angina in the presence of coronary artery disease is unknown. We evaluated the effect of chronic 17β-oestradiol therapy on exercise-induced myocardial ischaemia in 12 postmenopausal women (mean age 65 [SE 1] years) with atherosclerotic coronary heart disease.
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