Vascular actions of estrogens: Functional implications

Virginia M Miller, Sue P. Duckles

Research output: Contribution to journalArticle

296 Citations (Scopus)

Abstract

The impact of estrogen exposure in preventing or treating cardiovascular disease is controversial. But it is clear that estrogen has important effects on vascular physiology and pathophysiology, with potential therapeutic implications. Therefore, the goal of this review is to summarize, using an integrated approach, current knowledge of the vascular effects of estrogen, both in humans and in experimental animals. Aspects of estrogen synthesis and receptors, as well as general mechanisms of estrogenic action are reviewed with an emphasis on issues particularly relevant to the vascular system. Recent understanding of the impact of estrogen on mitochondrial function suggests that the longer lifespan of women compared with men may depend in part on the ability of estrogen to decrease production of reactive oxygen species in mitochondria. Mechanisms by which estrogen increases endothelial vasodilator function, promotes angiogen-esis, and modulates autonomic function are summarized. Key aspects of the relevant pathophysiology of inflammation, atherosclerosis, stroke, migraine, and thrombosis are reviewed concerning current knowledge of estrogenic effects. A number of emerging concepts are addressed throughout. These include the importance of estrogenic formulation and route of administration and the impact of genetic polymorphisms, either in estrogen receptors or in enzymes responsible for estrogen metabolism, on responsiveness to hormone treatment. The importance of local metabolism of estrogenic precursors and the impact of timing for initiation of treatment and its duration are also considered. Although consensus opinions are emphasized, controversial views are presented to stimulate future research.

Original languageEnglish (US)
Pages (from-to)210-241
Number of pages32
JournalPharmacological Reviews
Volume60
Issue number2
DOIs
StatePublished - Jun 2008

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Blood Vessels
Estrogens
Estrogen Receptors
Genetic Polymorphisms
Migraine Disorders
Vasodilator Agents
Reactive Oxygen Species
Atherosclerosis
Mitochondria
Thrombosis
Cardiovascular Diseases
Therapeutics
Stroke
Hormones
Inflammation
Enzymes

ASJC Scopus subject areas

  • Pharmacology

Cite this

Vascular actions of estrogens : Functional implications. / Miller, Virginia M; Duckles, Sue P.

In: Pharmacological Reviews, Vol. 60, No. 2, 06.2008, p. 210-241.

Research output: Contribution to journalArticle

Miller, Virginia M ; Duckles, Sue P. / Vascular actions of estrogens : Functional implications. In: Pharmacological Reviews. 2008 ; Vol. 60, No. 2. pp. 210-241.
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