© 2000 by European Society of Cardiology
Copyright © 2000, European Society of Cardiology
The roles of gender, the menopause and hormone replacement on cardiovascular function
aDepartment Cardiac Medicine National Heart and Lung Institute, Imperial College School of Medicine, London, UK
bCardiology Department, St Vincent's Hospital, Sydney, Australia
* Corresponding author. Tel.: +44-171-351-8112; fax: +44-171-823-3392 peter.collins@ic.ac.uk
Received 12 July 1999; accepted 12 November 1999
KEYWORDS Gender; Hormones; Epidemiology
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1 Introduction |
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While it is recognised that gender differences exist in cardiovascular disease, it has only recently been appreciated that significant gender differences also exist in cardiovascular function. Ageing is associated with a different spectrum of cardiac and vascular maladaptations in women compared to men. These differences may contribute to poorer outcome in women affected by ischaemic disease compared to men as well as the higher prevalence of symptomatic cardiac failure seen in women. The most obvious gender-related difference in physiological ageing is the menopause in women. The relation of this ‘event’ to cardiovascular disease has generated much controversy, especially with respect to hormone replacement therapy in the management of cardiac patients. Controversy also exists in the role of declining androgen levels in men with age and the advisability of testosterone supplementation in men. This review will examine gender differences which become apparent due to ageing, as well as the specific effect
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2 Gender and cardiovascular disease |
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3 Gender and cardiac physiology |
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3.1 Gender and cardiac size
3.2 Ageing and left ventricular mass
3.3 Left ventricular hypertrophy
3.4 Left ventricular function
3.5 Left ventricular failure
3.6 Animal models of gender and cardiac function
3.7 Gender and cardiac physiology — summary
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4 Gender and vascular physiology |
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4.1 Endothelial function
4.2 Large arterial function
4.3 Animal studies of gender and vascular function
4.4 Gender and vascular physiology — summary
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5 Menopause |
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5.1 Menopause and ventricular function
5.2 Animal studies of hormone withdrawal — effect on LV function
5.3 Menopause and vascular function
5.4 Menopause and cardiovascular function — summary
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6 Hormone replacement therapy in women |
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6.1 Hormone replacement therapy and ventricular function
6.2 Animal studies of hormone replacement — effect on LV function
6.3 Hormone replacement therapy and vascular function
6.4 Hormone replacement therapy and hypertension
6.5 Hormone replacement therapy and cardiovascular function — summary
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7 Supplemental androgens in men |
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7.1 Testosterone and ventricular function
7.2 Testosterone and vascular function
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8 Conclusions and recommendations |
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