© 2002 by European Society of Cardiology
Copyright © 2002, European Society of Cardiology
Endothelial function, vascular reactivity and gender differences in the cardiovascular system
aDepartment of Cardiology, Royal Prince Alfred Hospital, Missenden Road, Camperdown, 2050 NSW, Australia
bDepartment of Medicine, University of Sydney, Camperdown, 2006 NSW, Australia
* Corresponding author. Tel.: +61-2-9515-6519; fax: +61-2-9550-6262 davidc@card.rpa.cs.nsw.gov.au
Received 23 May 2001; accepted 21 August 2001
KEYWORDS Atherosclerosis; Endothelial function; Gender
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1. Introduction |
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A marked gender difference exists in the prevalence and severity of cardiovascular disease, even after adjustment for traditional vascular risk factors, which are more prevalent in males [1]. This has led to an interest in the role of sex steroids themselves in the promotion or inhibition of atherogenic events. As endothelial dysfunction is an early and important event in atherogenesis [2] and appears to predict adverse coronary outcomes [3], gender differences in endothelial function and the effects of hormonal therapy on vascular function have been the focus of considerable research interest.
The normal vascular endothelium regulates arterial tone, platelet and leukocyte interactions, coagulation, fibrinolysis and vascular growth [4]. Measurement of endothelial function in the systemic arteries has become established as an important method for the detection of early (pre-symptomatic) arterial abnormalities in humans [5]. Ultrasound-detected endothelial dysfunction in peripheral arteries correlates significantly with coronary endothelial dysfunction
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2. Normal endothelial function |
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3. Mechanisms of hormonal regulation of endothelial function |
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4. Assessment of the effects of gender and hormones on endothelial function in vivo |
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5. Gender, hormones and endothelial function |
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6. Effects of ‘physiological’ levels of sex hormones on endothelial function |
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6.1. Gender
6.2. Age
6.3. Menstrual cycle
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7. ‘Pharmacological’ doses of sex hormones' effects on endothelial function |
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7.1. Oestrogens in post-menopausal women
7.2. Oestrogens in men
7.3. Androgens in men
7.4. Androgens in women
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8. Conclusion |
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