Sex steroids and the endothelium

Gonadal steroids clearly influence the course of atherosclerotic cardiovasc ular disease in women. This observation has suggested that these hormones h ave beneficial effects on the physiology of the vascular wall. increased ar terial vascular caliber after estrogen treatment, decreased lipid levels in subjects receiving hormone replacement therapy, and the markedly decreased extent of atherosclerotic plaque formation in young women as compared with young men support a cardioprotective effect of ovarian steroids. Generally , it appears that the effects of 17 beta-estradiol are particularly benefic ial, and the mechanism of action is targeted largely to the endothelial cel l. This review describes the evidence for positive effects of estrogens on endothelial cell biology and considers potential mechanisms for estrogen ac tions on endothelial cell signal transduction.