EFFECT OF ESTROGENS ON THE CARDIOVASCULAR-SYSTEM

There is an ongoing discussion on the risk-benefit-ratio of hormonal r eplacement therapy (HRT). Potential risks of oestrogen replacement inc lude the progression of malignant tumours. However postmenopausal morb idity can be significantly reduced by HRT. There is increasing evidenc e that oestrogens exercise protective effects on the cardiovascular sy stem. HRT can reduce the development of atherosclerotic lesions and th e rate of fatal myocardial infarction due to atherosclerosis. Oestroge ns have direct and indirect effects on vascular physiology. Indirect e ffects derive from modulation of lipid metabolism. In addition, oestro gens may exert direct effects on vascular cells e.g. endothelial and s mooth muscle cells by receptor-mediated mechanisms (so called genomic effects) and receptor-independent actions (=non-genomic effects). Espe cially these non-genomic oestrogen effects have been attracting much a ttention during recent years.