Role of estrogens, selective estrogen receptor modulators and phytoestrogens in cardiovascular protection

A large body of evidence suggests chat estrogen may be of benefit in reduci ng the risk of heart disease in postmenopausal women. The mechanism by whic h. this benefit is conferred has been the subject of numerous investigation s. III addition to the well known effects of estrogen on lipids, estrogen e xerts a number of endothelium-dependent effects related to both vasodilatio n and nitric oxide metabolism that may have a favourable impact on vascular health. However, this benefit has not yet been confirmed in randomized cli nical trials. indeed, the only large trial published to date failed to docu ment a benefit in women with established heart disease. Recent studies have shown that estrogen may also have some prothrombotic or proinflammatory ef fects that may offset other benefits. The extent to which selective estroge n receptor modulators and phytoestrogens share in the beneficial and potent ially harmful effects of estrogen is not yet established.