Effect of oestrogens on the cardiovascular system

There is an ongoing discussion on the risk-benefit-ratio of hormonal recpla cement therapy (HRT). Potential risks of oestrogen replacement include the progression of malignant tumours. However postmenopausal morbidity can be s ignificantly reduced by HRT. There is increasing evidence that oestrogens e xercise protective effects on the cardiovascular system. HRT can reduce the development of atherosclerotic lesions and the rate of fatal myocardial in farction due to atherosclerosis. Oestrogens have direct and indirect effect s on vascular physiology. Indirect effects derive from modulation of lipid metabolism. In addition, oestrogens may exert direct effects on vascular ce lls e. g. endothelial and smooth muscle cells by receptor-mediated mechanis ms (so called genomic effects) and receptor-independent actions (= non-geno mic effects). Especially these non-genomic oestrogens effects have been att racting much attention during recent years.