Protektion des kardiovaskulären Systems durch Östrogene

Kardiovaskuläre Erkrankungen stellen die Haupttodesursache bei Frauen in den westlichen Industrienationen dar [1] [2] [3] . In Abhängigkeit vom Alter bestehen geschlechtsspezifische Unterschiede bezüglich der Inzidenz kardiovaskulärer Erkrankungen. Diese werden durch unterschiedliche Riskofaktoren und die weiblichen Geschlechtshormone erklärt [2] [3] [4] [5] . In diesem Zusammenhang sind direkte Wirkungen der Östrogene auf die Zellen der Gefäßwand in den Mittelpunkt des Interesses gerückt, und zwar aus wissenschaftlicher wie auch aus gesundheitspolitischer Sicht.

Literatur

• 1 Colditz G A, Willett W C, Stampfer M J, Rosner B, Speizer F E, Hennekens C H. Menopause and the risk of coronary heart disease in women.  N Engl J Med. 1987;  316 1105-1110
• 2 Wenger N K, Speroff L, Packard B. Cardiovascular health and disease in women (see comments).  N Engl J Med. 1993;  329 247-256
• 3 Wenger N K. Hypertension and other cardiovascular risk factors in women.  Am J Hypertens. 1995;  8 94s-99s
• 4 Nabulsi A A, Folsom A R, White A, Patsch W, Heiss G, Wu K K, Szklo M. Association of hormone-replacement therapy with various cardiovascular risk factors in postmenopausal women. The Atherosclerosis Risk in Communities Study Investigators (see comments).  N Engl J Med. 1993;  328 1069-1075
• 5 Ross R. The pathogenesis of atherosclerosis: A perspective for the 1990s.  Nature. 1993;  362 801-809
• 6 Wilson P W. Established risk factors and coronary artery disease: The Framingham Study.  Am J Hypertens. 1994;  7 7S-12S
• 7 Faulhaber H D, Luft F C. Treatment of high blood pressure in Germany.  Am J Hypertens. 1998;  11 750-753
• 8 Keating N L, Cleary P D, Rossi A S, Zaslavsky A M, Ayanian J Z. Use of hormone replacement therapy by postmenopausal women in the United States.  Ann Intern Med. 1999;  130 545-553
• 9 Grady D, Rubin S M, Petitti D B, Fox C S, Black D, Ettinger B, Ernster V L, Cummings S R. Hormone therapy to prevent disease and prolong life in postmenopausal women (see comments).  Ann Intern Med. 1992;  117 1016-1037
• 10 Psaty B M, Heckbert S R, Atkins D, Siscovick D S, Koepsell T D, Wahl P W, Longstreth W TJ, Weiss N S, Wagner E H, Prentice R. A review of the association of estrogens and progestins with cardiovascular disease in postmenopausal women.  Arch Intern Med. 1993;  153 1421-1427
• 11 Sidney S, Petitti D B, Quesenberry C PJ. Myocardial infarction and the use of estrogen and estrogen-progestogen in postmenopausal women.  Ann Intern Med. 1997;  127 501-508
• 12 Heckbert S R, Weiss N S, Koepsell T D, Lemaitre R N, Smith N L, Siscovick D S, Lin D, Psaty B M. Duration of estrogen replacement therapy in relation to the risk of incident myocardial infarction in postmenopausal women.  Arch Intern Med. 1997;  157 1330-1336
• 13 Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B, Vittinghoff E. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group (see comments).  JAMA. 1998;  280 605-613
• 14 Castelli W P, Anderson K. A population at risk. Prevalence of high cholesterol levels in hypertensive patients in the Framingham Study.  Am J Med. 1986;  80 23-32
• 15 Hong M K, Romm P A, Reagan K, Green C E, Rackley C E. Effects of estrogen replacement therapy on serum lipid values and angiographically defined coronary artery disease in postmenopausal women (see comments).  Am J Cardiol. 1992;  69 176-178
• 16 Cauley J A, La P R, Kuller L H, Bates M, Sandler R B. Menopausal estrogen use, high density lipoprotein cholesterol subfractions and liver function.  Atherosclerosis. 1983;  49 31-39
• 17 Sugikowa K, Shimeosegawa Y, Nakano M. Estrogens as natural antioxidants of membrane phospholipid peroxidation.  FEBS Lett. 1987;  210 37-39
• 18 Erkkola R, Lammintausta R, Punnonen R, Rauramo L. The effect of estriol succinate therapy on plasma renin activity and urinary aldosterone in postmenopausal women.  Maturitas. 1978;  1 9-14
• 19 Hassager C, Riis B J, Strom V, Guyene T T, Christiansen C. The long-term effect of oral and percutaneous estradiol on plasma renin substrate and blood pressure.  Circulation. 1987;  76 753-758
• 20 Kaulhausen H, Venn H J, Muhlbauer W, Beck K J, Breuer H. Effect of ethinyl estradiol on renin activity and on the concentrations of renin substrate and aldosterone in plasma of ovariectomized women.  Arch Gynecol. 1980;  229 29-36
• 21 Schunkert H, Danser A H, Hense H W, Derkx F H, Kurzinger S, Riegger G A. Effects of estrogen replacement therapy on the renin-angiotensin system in postmenopausal women.  Circulation. 1997;  95 39-45
• 22 Laufs U, Erdmann E. Stickstoffmonoxid als Signalmolekul im Herz-Kreislaufsystem. Nobelpreis für Medizin 1998.  Dtsch Med Wschr. 1998;  123 1562-1565
• 23 Morey A K, Razandi M, Pedram A, Hu R -M, Prins B A, Levin E R. Oestrogen and progesterone inhibit the stimulated production of endothelin-1.  Biochem J. 1998;  330 1097-1105
• 24 Grohé C, Kahlert S, Lobbert K, van Eickels M, Stimpel M, Vetter H, Neyses L. Effects of moexiprilat on oestrogen-stimulated cardiac fibroblast growth.  Br J Pharmacol. 1997;  121 1350-1354
• 25 Chen Z, Yuhanna I S, Galcheva-Gargova Z, Karas R H, Mendelsohn M E, Shaul P W. Estrogen receptor alpha mediates the nongenomic activation of endothelial nitric oxide synthase by estrogen.  J Clin Invest. 1999;  103 401-406
• 26 Grohé C, Kahlert S, Löbbert K, Stimpel M, Karas R H, Vetter H, Neyses L. Cardiac myocytes and fibroblasts contain functional estrogen receptors.  FEBS Lett. 1997;  416 107-112
• 27 Karas R H, Patterson B L, Mendelsohn M E. Human vascular smooth muscle cells contain functional estrogen receptor.  Circulation. 1994;  89 1943-1950
• 28 Lindner V, Kim S K, Karas R H, Kuiper G G, Gustafsson J A, Mendelsohn M E. Increased expression of estrogen receptor-beta mRNA in male blood vessels after vascular injury.  Circ Res. 1998;  83 224-229
• 29 Dzau V J, Burt D W, Pratt R E. Molecular biology of the renin-angiotensin system.  Am J Physiol. 1988;  255 F563-F573
• 30 Griendling K K, Murphy T J, Alexander R W. Molecular biology of the renin-angiotensin system.  Circulation. 1993;  87 1816-1828
• 31 Griendling K K, Lassegue B, Murphy T J, Alexander R W. Angiotensin II receptor pharmacology.  Adv Pharmacol. 1994;  28 269-306
• 32 Mukoyama M, Nakajima M, Horiuchi M, Sasamura H, Pratt R E, Dzau V J. Expression cloning of type 2 angiotensin II receptor reveals a unique class of seven-transmembrane receptors.  J Biol Chem. 1993;  268 24539-24542
• 33 Murphy T J, Alexander R W, Griendling K K, Runge M S, Bernstein K E. Isolation of a cDNA encoding the vascular type-1 angiotensin II receptor.  Nature. 1991;  351 233-236
• 34 Murphy T J, Takeuchi K, Alexander R W. Molecular cloning of AT1 angiotensin receptors.  Am J Hypertens. 1992;  5 236S-242S
• 35 Sasaki K, Yamano Y, Bardhan S, Iwai N, Murray J J, Hasegawa M, Matsuda Y, Inagami T. Cloning and expression of a complementary DNA encoding a bovine adrenal angiotensin II type-1 receptor.  Nature. 1991;  351 230-233
• 36 Nickenig G, Murphy T J. Down-regulation by growth factors of vascular smooth muscle angiotensin receptor gene expression.  Mol Pharmacol. 1994;  46 653-659
• 37 Nickenig G, Sachinidis A, Michaelsen F, Böhm M, Seewald S, Vetter H. Upregulation of vascular angiotensin II receptor gene expression by low-density lipoprotein in vascular smooth muscle cells.  Circulation. 1997;  95 473-478
• 38 Nickenig G, Strehlow K, Roeling J, Zolk O, Knorr A, Böhm M. Salt induces vascular AT1 receptor overexpression in vitro and in vivo.  Hypertension. 1998;  31 1272-1277
• 39 Nickenig G, Röling J, Strehlow K, Schnabel P, Böhm M. Insulin induces upregulation of vascular AT1 receptor gene expression by posttranscriptional mechanisms.  Circulation. 1998;  98 2453-2460
• 40 Nickenig G, Baumer A T, Grohé C, Kahlert S, Strehlow K, Rosenkranz S, Stablein A, Beckers F, Smits J F, Daemen M J, Vetter H, Böhm M. Estrogen modulates AT1 receptor gene expression in vitro and in vivo.  Circulation. 1998;  97 2197-2201
• 41 Nickenig G, Bäumer A T, Böhm M. Die pathophysiologische Bedeutung der AT1-Rezeptorregulation während der Östrogendefizienz.  Herz/Kreislauf. 1998;  30 24-27
• 42 Nickenig G, Bäumer A T, Böhm M. Angiotensin II antagonism and blood pressure control in women.  The British Journal of Cardiology. 1999;  6 351-354
• 43 Gerhard M, Walsh B W, Tawakol A, Haley E A, Creager S J, Seely E W, Ganz P, Creager M A. Estradiol therapy combined with progesterone and endothelium-dependent vasodilation in postmenopausal women.  Circulation. 1998;  98 1158-1163
• 44 Lewis C E, Grandits A, Flack J, McDonald R, Elmer P J. Efficacy and tolerance of antihypertensive treatment in men and women with stage 1 diastolic hypertension. Results of the Treatment of Mild Hypertension Study.  Arch Intern Med. 1996;  156 377-385
• 45 Meade T W, Berra A. Hormone replacement therapy and cardiovascular disease.  Br Med Bull. 1992;  48 276-308
• 46 Timmermans P B, Wong P C, Chiu A T, Herblin W F, Benfield P, Carini D J, Lee R J, Wexler R R, Saye J A, Smith R D. Angiotensin II receptors and angiotensin II receptor antagonists.  Pharmacol Rev. 1993;  45 205-251
• 47 Malmqvist K. In hypertensive women, candesartan cilexetil lowers blood pressure more and causes less adverse events in comparison to enalapril and hydrochlorothiazide. Abstract book from the International Forum on Angiotensin II Receptor Antagonism, Monte Carlo 1999,: 28

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