Atherosclerosis and sex hormones: Current concepts

Amparo C. Villablanca, Muthuvel Jayachandran, Carole Banka

Research output: Contribution to journalReview article

64 Citations (Scopus)

Abstract

CVD (cardiovascular disease) is the leading cause of death for women. Considerable progress has been made in both our understanding of the complexities governing menopausal hormone therapy and our understanding of the cellular and molecularmechanisms underlying hormone and hormone receptor function. Understanding the interplay of atherosclerosis and sex steroid hormones and their cognate receptors at the level of the vessel wall has important ramifications for clinical practice. In the present review, we discuss the epidemiology of CVD in men and women, the clinical impact of sex hormones on CVD, and summarize our current understanding of the pathogenesis of atherosclerosis with a focus on gender differences in CVD, its clinical presentation and course, and pathobiology. The critical animal and human data that pertain to the role of oestrogens, androgens and progestins on the vesselwall is also reviewed, with particular attention to the actions of sex hormones on each of the three key cell types involved in atherogenesis: the endothelium, smooth muscle cells and macrophages. Where relevant, the systemic (metabolic) effects of sex hormones that influence atherogenesis, such as those involving vascular reactivity, inflammation and lipoprotein metabolism, are discussed. In addition, four key current concepts in the field are explored: (i) total hormone exposure time and coronary heart disease risk; (ii) the importance of tissue specificity of sex steroid hormones, critical timing and the stage of atherosclerosis in hormone action; (iii) biomarkers for atherosclerosis with regard to hormone therapy; and (iv) the complex role of sex steroids in inflammation. Future studies in this field will contribute to guiding clinical treatment recommendations for women and help define research priorities.

Original languageEnglish (US)
Pages (from-to)493-513
Number of pages21
JournalClinical Science
Volume119
Issue number12
DOIs
StatePublished - Dec 2010

Fingerprint

Gonadal Steroid Hormones
Atherosclerosis
Hormones
Cardiovascular Diseases
Inflammation
Organ Specificity
Progestins
Androgens
Lipoproteins
Smooth Muscle Myocytes
Endothelium
Coronary Disease
Blood Vessels
Cause of Death
Estrogens
Epidemiology
Therapeutics
Biomarkers
Macrophages
Steroids

Keywords

  • Androgen
  • Atherosclerosis
  • Cardiovascular disease
  • Cell type
  • Gender
  • Oestrogen
  • Progesterone

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Villablanca, A. C., Jayachandran, M., & Banka, C. (2010). Atherosclerosis and sex hormones: Current concepts. Clinical Science, 119(12), 493-513. https://doi.org/10.1042/CS20100248

Atherosclerosis and sex hormones : Current concepts. / Villablanca, Amparo C.; Jayachandran, Muthuvel; Banka, Carole.

In: Clinical Science, Vol. 119, No. 12, 12.2010, p. 493-513.

Research output: Contribution to journalReview article

Villablanca, AC, Jayachandran, M & Banka, C 2010, 'Atherosclerosis and sex hormones: Current concepts', Clinical Science, vol. 119, no. 12, pp. 493-513. https://doi.org/10.1042/CS20100248
Villablanca AC, Jayachandran M, Banka C. Atherosclerosis and sex hormones: Current concepts. Clinical Science. 2010 Dec;119(12):493-513. https://doi.org/10.1042/CS20100248
Villablanca, Amparo C. ; Jayachandran, Muthuvel ; Banka, Carole. / Atherosclerosis and sex hormones : Current concepts. In: Clinical Science. 2010 ; Vol. 119, No. 12. pp. 493-513.
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