Estrogen and Vascular Reactivity

Cardiovascular disease is the leading cause of death in American women, claiming more lives than cancer, diabetes, and accidents combined (1,2). The risk of myocardial infarction and stroke increases dramatically in women after the menopause (3). Of women ages 45-64 yr, one of nine have cardiovascular disease; yet after age 65, the ratio increases to one of three (2). Loss of endogenous estrogens associated with menopause contributes to the increased cardiovascular risk. Conversely, in postmenopausal women taking estrogen replacement therapy, population-based studies indicate there are up to 50% fewer cardiovascular events (4,5). These observations support an important role for estrogen replacement therapy in the prevention of cardiovascular disease.