Estrogen and cardiovascular disease

Prog Cardiovasc Dis. 2024 May-Jun:84:60-67. doi: 10.1016/j.pcad.2024.01.015. Epub 2024 Jan 24.

Abstract

A large body of scientific research accumulated over the past twenty years documents the cardiovascular (CV) benefits of estradiol (E2) and progesterone (P4) in reproductive aged women. In contrast, accelerated development of CV disease (CVD) occurs in the absence of ovarian produced E2 and P4. Hormone replacement therapy (HRT) with E2 and P4 has been shown to cause no harm to younger menopausal women. This robust scientific data supports a reconsideration of the prescriptive use of E2 and P4 as preventative therapeutics for the reduction of CVD, even without additional large-scale studies of the magnitude of the Women's Health Initiative (WHI). With the current expanded understanding of the critical modulatory role played by E2 on a multitude of systems and enzymes impacting CVD onset, initiation of HRT shortly after cessation of ovarian function, known as the "Timing Hypothesis", should be considered to delay CVD in recently postmenopausal women.

Keywords: Cardiovascular disease; Estrogen; Hormone replacement therapy; Menopause; Women.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / prevention & control
  • Cardiovascular System / drug effects
  • Cardiovascular System / metabolism
  • Cardiovascular System / physiopathology
  • Estradiol / metabolism
  • Estradiol / therapeutic use
  • Estrogen Replacement Therapy* / adverse effects
  • Estrogens* / adverse effects
  • Estrogens* / metabolism
  • Female
  • Heart Disease Risk Factors
  • Humans
  • Menopause / metabolism
  • Progesterone / metabolism
  • Progesterone / therapeutic use
  • Protective Factors
  • Risk Assessment
  • Risk Factors
  • Women's Health

Substances

  • Estrogens
  • Progesterone
  • Estradiol