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Estrogen and Cardiovascular Health

The age-related decline in estrogen increases one’s risk of heart disease. This is because estrogen is believed to play a crucial role in the maintenance of a healthy heart by keeping blood vessels flexible, thereby improving the heart’s pumping power and overall blood circulation. In addition, falling estrogen levels increase blood pressure, blood sugar and cholesterol levels – all of which are major risk factors for heart disease! Recent research adds to the evidence that estrogen protects against heart attack and other adverse cardiovascular events:
1. Transdermal ERT may actually reduce the risk of heart disease among smokers and obese patients. [357-358]
2. Results from observational studies assessing the safety and benefit of ERT in young menopausal women show that local administration of estrogen in the form of vaginal creams, vaginal rings and transdermal patches is not associated with any adverse cardiovascular events. [359-360]
3. Observational studies also show that postmenopausal women who receive ERT have a lower rate of cardiovascular disease and cardiac death than those not receiving ERT. [361-362]
4. Estrogen helps activate nitric oxide, which in turn dilates the blood vessels of the heart and improves blood circulation. [363-366]
5. In the heart, estrogen receptors preserve cardiac function and protect against tissue damage caused by lack of oxygen (ischemia). [367-368]
6. Estrogen protects against heart disease by reducing oxidative stress, which is one of the major causes of heart failure. [369-372]
7. Estrogen has a profound antiapoptotic (prevents cells death) and pro-survival effect on heart muscle cells (cardiomyocytes). [373-374]
8. Estrogen protects against heart disease by reducing inflammatory markers. [375-376]
9. Estrogen promotes migration of stem cells into the injured heart muscle after ischemia, thereby improving endothelial and myocardial function. [377-379]
10. ERT decreases the risk of cardiovascular disease (CVD) and reduces mortality in postmenopausal women with heart disease. [380-381]
11. ERT use early after menopause significantly reduces risk of mortality, heart failure, or myocardial infarction. [382-386]
12. ERT use in postmenopausal women is associated with the cessation and potentially with the reversal of the progression of carotid artery atherosclerosis (plaque build-up) as assessed by ultrasonography. [387]
13. Estrogen exerts its antiatherogenic activity (fights plaque build-up) by improving cholesterol levels and preventing oxidation in the walls of the blood vessels of the heart. [388-395]
14. In postmenopausal women with stable angina, atypical chest pain, or an abnormal exercise electrocardiogram (ECG), intravenous administration of estrogen significantly improves blood flow to the heart. [396-397]
15. In postmenopausal women, ERT significantly increases brachial arterial blood flow, which is an independent marker of blood circulation in the heart. [398-403]

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