Skip to main content
SpringerLink
Log in

Hormones and coronary atherosclerosis in women

  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

Heart disease is the major health issue facing women in the United States today. Yet, less than 50% of women are aware cardiovascular disease is a health problem. Atherosclerosis begins in childhood and lipid streaks have been identified in girls ages 15–19 in the abdominal aorta and the right coronary artery. Risk factors for cardiovascular disease in women include smoking, diabetes, hypertension, lipid disorders, and menopause. Observational studies have reported a 30–50% reduction in cardiovascular events when estrogen was administered to younger women for menopausal symptoms, yet randomized trials in older patients have failed to show benefit with hormonal replacement therapy. Recent studies have reported preservation of lipid and vascular vasodilatation with low-dose conjugated equine estrogens (CEE) in women and an absence of inflammatory and clotting changes that were observed in high-dose CEE. Recommendations for reducing cardiovascular risk in postmenopausal women include smoking cessation, regular exercise, and weight control. Should hormone therapy be continued beyond management of menopausal symptoms and treatment for osteoporosis, a statin drug should be added to eliminate future cardiovascular complications. Future research will examine low-dose hormonal therapy, earlier administration after menopause, newer agents, and routes of estrogen administration.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. National Center for Health Statistics (1999). pp. 164–167.

  2. Mosca, L., Ferris, A., Fabunmi, R., and Robertson, R. M. (2004). Circulation 109, 573–579.

    Article  PubMed  Google Scholar 

  3. Wenger, N. K. (2004) Circulation 109, 558–560.

    Article  PubMed  Google Scholar 

  4. Virchow, R. (1858).

  5. Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. (1999). JAMA 298, 727–735.

    Google Scholar 

  6. Napoli, C., D’Aromento, F. P., Mancini, F. T., et al. (1997). J. Clin. Invest. 100, 2680–26990.

    Article  PubMed  CAS  Google Scholar 

  7. Rackley, C. E. and Rackley, E. B. (1999). J. Noninvas. Cardiol. 3, 95–99.

    Google Scholar 

  8. Little, W. C., Constantinescu, M., Applegate, R. J., et al. (1988). Circulation 78, 1157–1166.

    PubMed  CAS  Google Scholar 

  9. Rackley, C. E. (2002). Cardiology in Review 10, 119–125.

    Article  PubMed  Google Scholar 

  10. Hsia, J., Aragaki, A., Bloch, M., LaCroix, A. Z., Wallace, R., for the WHI Investigators. (2004). Am. J. Cardiol. 93, 673–678.

    Article  PubMed  Google Scholar 

  11. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. (Adult Treatment Panel III). (2001). JAMA 285, 2486–2497.

    Article  Google Scholar 

  12. Heilbron, L. K., NoAkes, M., and Clifton, P. M. (2001). Arterioscler. Thromb. Vasc. Biol. 21, 968–970.

    Google Scholar 

  13. Kip, K. E., Marroquin, O. C., Kelley, D. E., et al. (2004). Circulation 109, 706–713.

    Article  PubMed  Google Scholar 

  14. Clarkson, T. B., Kaplan, J. R., Wagner, J. D., et al. (2002). Cardiovascular health and disease in women. 2nd ed. Harcourt Health Sciences/W. B. Saunders, Philadelphia, PA, Chapter 13, p. 231.

    Google Scholar 

  15. Post, W., Goldschmidt-Clearmont, P. J., Wilhide, C. C. et al. (1999). Cardiovas. Res. 43, 985–991.

    Article  CAS  Google Scholar 

  16. Sullivan, J. M., Vander Zwaag, R., Lemp, G. F., et al. (1988). Ann. Inter. Med. 108, 358–363.

    CAS  Google Scholar 

  17. Hong, M. K., Romm, P. A., Reagan, K., Green, C. E., and Rackley, C. E. (1992). Am. J. Cardiol. 69, 176–178.

    Article  PubMed  CAS  Google Scholar 

  18. Husak, L., Vaccarino, V., Veledar, E., Murrah, N., and Wenger, N. K. (2004). Am. J. Cardiol. 93, 563–568.

    Article  PubMed  CAS  Google Scholar 

  19. Williams, J. K., Anthony, M. S., Honore, E. K. et al. (1995) Arterioscler. Thromb. Vasc. Biol. 15, 827–836.

    PubMed  CAS  Google Scholar 

  20. Lindsay, R., Hart, D. M., Aitken, J. M., et al. (1976). Lancet 1, 1038–1041.

    Article  PubMed  CAS  Google Scholar 

  21. Hulley, F., Grady, D., Bush, T., et al. (1998). JAMA 280, 605–613.

    Article  PubMed  CAS  Google Scholar 

  22. Writing Group for the Women’s Health Initiative Investigators. (2002). JAMA 288, 321–333.

    Article  Google Scholar 

  23. Koh, K. K., Ahn, J. Y., Seung, H. H., Shin, M. S., Ahn, T. H., and Shin, E. K. (2004). J. Am. Coll. Cardiol. 43, 5–3A.

    Google Scholar 

  24. Wakatshuki, A., Ikenoue, N., Shinohara, K., Watanave, K., and Furkay, T. (2004). Arterioscler. Thromb. Vasc. Biol. 24, 571–576.

    Article  CAS  Google Scholar 

  25. Stampfer, M. J., Willett, W. C., Colditz, G. A., Rosner, B., Speizer, F. E., and Hennekens, C. H. (1985). N. Engl. J. Med. 313, 1044–1049.

    Article  PubMed  CAS  Google Scholar 

  26. Falkeborn, M., Persson, I., Adami, H. O., et al. (1992). Br. J. Obstet. Gynecol. 99, 821–827.

    CAS  Google Scholar 

  27. Goldstein, F., Stampfer, M. J., Manson, J. E., et al. (1996). N. Engl. J. Med. 335, 453–461.

    Article  Google Scholar 

  28. Grodstein, F., Manson, J. E., Colditz, G. A., et al. (2000). Ann. Intern. Med. 133, 933–942.

    PubMed  CAS  Google Scholar 

  29. Hsia, J., Manson, J. E., Johnson, K. C., et al., for the Women’s Health Initiative Investigators. (2003). Circulation 108, IV-787.

  30. Hambrecht, R., Walther, C., Molrus-Winhler, S. Gielen, S., et al. (2004). Circulation 109, 1371–1378.

    Article  PubMed  Google Scholar 

  31. Abisaid, A., Albertal, M., Costa, M. A., et al. (2004). J. Am. Coll. Cardiol. 43, 1118–1121.

    Article  CAS  Google Scholar 

  32. Dorons, J. R., Clearfield, M., Weis, S. et al. (1998). JAMA 279, 1615–1622.

    Article  Google Scholar 

  33. Herrington, D. M., Viltinghoff, E., Lin, F., et al. (2002). Circulation 105, 2962–2967.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Georgetown University Medical Center, 20007-2197, Washington, DC

    Charles E. Rackley (Division of Cardiology, Director of Lipid Disorder Center)

Authors
  1. Charles E. Rackley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Charles E. Rackley.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rackley, C.E. Hormones and coronary atherosclerosis in women. Endocr 24, 245–250 (2004). https://doi.org/10.1385/ENDO:24:3:245

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1385/ENDO:24:3:245

Key Words

Search

Navigation