Horm Metab Res 2013; 45(10): 701-708
DOI: 10.1055/s-0033-1343478
Review
© Georg Thieme Verlag KG Stuttgart · New York

Anti-atherogenic Effects of 17β-Estradiol

I. Resanovic
1   Laboratory of Radiobiology and Molecular Genetics, Institute Vinca, University of Belgrade, Belgrade, Serbia
,
M. Rizzo
2   BioMedical Department of Internal Medicine and Medical Specialties, University of Palermo, Italy
3   Euro-Mediterranean Institute of Science and Technology, Italy
,
S. Zafirovic
1   Laboratory of Radiobiology and Molecular Genetics, Institute Vinca, University of Belgrade, Belgrade, Serbia
,
P. Bjelogrlic
4   School of Medicine, University of St. Andrews, St. Andrews, Scotland, UK
,
M. Perovic
5   University Clinic of Gynecology and Obstetrics “Narodni front”, University of Belgrade, Belgrade, Serbia
,
K. Savic
1   Laboratory of Radiobiology and Molecular Genetics, Institute Vinca, University of Belgrade, Belgrade, Serbia
,
A. M. Patti
6   BioMedical Department of Internal Medicine and Medical Specialties, ­University of Palermo, Italy
,
R. E. Isenovic
1   Laboratory of Radiobiology and Molecular Genetics, Institute Vinca, University of Belgrade, Belgrade, Serbia
› Author Affiliations
Further Information

Publication History

received 16 November 2012

accepted 02 April 2013

Publication Date:
16 May 2013 (online)

Abstract

Estrogens are secreted primarily by the ovaries and placenta, by the testes in men and also produced by peripheral steroidogenic conversion. The 3 major naturally occurring estrogens are: 17β-estradiol (E2), estrone and estriol, of which E2 is the predominant and most active. The actions of E2 are mediated by at least 3 different receptors – the classical ERs (ERα and ERβ) and G-protein coupled receptor 30 (GPR30). E2 signaling in cardiomyocytes involves ERα- and ERβ-independent pathways, and treatment with the E2 receptor antagonists (Selective Estrogen Receptor Modulators- SERMs), which are agonists of GPR30, inhibits cardiac cell growth. Effects of E2 in preventing endothelial dysfunction, a prerequisite of atherosclerosis, are well recognized. Atherosclerosis involves interaction between the cells of the arterial wall endothelial cells (EC) and vascular smooth muscle cell (VSMC), as well as migration of macrophages into wall tunica media. It is predominantly developed at sites with abnormally high shear stress, such as bifurcations or branching of arteries, initiated by an injury to the endothelium and exposure to atherogenic lipids and toxins, such as those contained in tobacco smoke or infectious agents. Animal studies have shown effects of E2 in preventing atherosclerosis, inflammation and endothelial or vascular dysfunction. Gender differences along this pathogenic pathway have been also described. We review the data from the available animal and human studies, which focus on anti-atherogenic effects of E2. These studies represent evidence, albeit indirect, for an inhibitory effect of E2 on the progression of coronary artery atherosclerosis.

 
  • References

  • 1 Stojanovic ND, Kwong P, Byrne DJ, Arnold A, Jagroop IA, Nair D, Press M, Hurel S, Mikhailidis DP, Prelevic GM. The effects of transdermal estradiol alone or with cyclical dydrogesterone on markers of cardiovascular disease risk in postmenopausal women with type 2 diabetes: a pilot study. Angiology 2003; 54: 391-399
  • 2 Prelevic GM, Kwong P, Byrne DJ, Jagroop IA, Ginsburg J, Mikhailidis DP. A cross-sectional study of the effects of hormon replacement therapy on the cardiovascular disease risk profile in healthy postmenopausal women. Fertil Steril 2002; 77: 945-951
  • 3 Dahlman-Wright K, Cavailles V, Fuqua SA, Jordan VC, Katzenellenbogen JA, Korach KS, Maggi A, Muramatsu M, Parker MG, Gustafsson JA. International Union of Pharmacology. LXIV. Estrogen receptors. Pharmacol Rev 2006; 58: 773-781
  • 4 Wassmann S, Baumer AT, Strehlow K, van Eickels M, Grohe C, Ahlbory K, Rosen R, Bohm M, Nickenig G. Endothelial dysfunction and oxidative stress during estrogen deficiency in spontaneously hypertensive rats. Circulation 2001; 103: 435-441
  • 5 Ruiz-Sanz JI, Navarro R, Martinez R, Martin C, Lacort M, Matorras R, Ruiz-Larrea MB. 17beta-estradiol affects in vivo the low density lipoprotein composition, particle size, and oxidizability. Free Radic Biol Med 2001; 31: 391-397
  • 6 Cossette E, Cloutier I, Tardif K, DonPierre G, Tanguay JF. Estradiol inhibits vascular endothelial cells pro-inflammatory activation induced by C-reactive protein. Mol Cell Biochem 2013; 373: 137-147
  • 7 Isenovic ER, Divald A, Milivojevic N, Grgurevic T, Fisher SE, Sowers JR. Interactive effects of insulin-like growth factor-1 and beta-estradiol on endothelial nitric oxide synthase activity in rat aortic endothelial cells. Metabolism 2003; 52: 482-487
  • 8 Chambliss KL, Shaul PW. Estrogen modulation of endothelial nitric oxide synthase. Endocr Rev 2002; 23: 665-686
  • 9 Meyer MR, Barton M. ERalpha, ERbeta, and gpER: novel aspects of oestrogen receptor signalling in atherosclerosis. Cardiovasc Res 2009; 83: 605-610
  • 10 Rosano GM, Fini M. Postmenopausal women and cardiovascular risk: impact of hormone replacement therapy. Cardiol Rev 2002; 10: 51-60
  • 11 Wren BG. The benefits of oestrogen following menopause: why hormone replacement therapy should be offered to postmenopausal women. Med J Aust 2009; 190: 321-325
  • 12 Horstman AM, Dillon EL, Urban RJ, Sheffield-Moore M. The role of androgens and estrogens on healthy aging and longevity. J Gerontol A Biol Sci Med Sci 2012; 67: 1140-1152
  • 13 Mendelsohn ME, Karas RH. Molecular and cellular basis of cardiovascular gender differences. Science 2005; 308: 1583-1587
  • 14 Akishita M, Yu J. Hormonal effects on blood vessels. Hypertens Res 2012; 35: 363-369
  • 15 Heldring N, Pike A, Andersson S, Matthews J, Cheng G, Hartman J, Tujague M, Strom A, Treuter E, Warner M, Gustafsson JA. Estrogen receptors: how do they signal and what are their targets. Physiol Rev 2007; 87: 905-931
  • 16 Lucas TF, Pimenta MT, Pisolato R, Lazari MF, Porto CS. 17beta-estradiol signaling and regulation of Sertoli cell function. Spermatogenesis 2011; 1: 318-324
  • 17 Boon WC, Chow JD, Simpson ER. The multiple roles of estrogens and the enzyme aromatase. Prog Brain Res 2010; 181: 209-232
  • 18 Mandusic V, Radak D, Markicevic M, Perovic M, Obradovic M, Mikhailidis DP, Isenovic ER. Role of estrogen and estrogen receptors in cancer pathology. Endocrine studies 2011; 1 (e5) 9-23
  • 19 Chakrabarti S, Davidge ST. G-Protein Coupled Receptor 30 (GPR30): A Novel Regulator of Endothelial Inflammation. PLoS One 2012; 7: e52357
  • 20 Ihionkhan CE, Chambliss KL, Gibson LL, Hahner LD, Mendelsohn ME, Shaul PW. Estrogen causes dynamic alterations in endothelial estrogen receptor expression. Circ Res 2002; 91: 814-820
  • 21 Jensen EV, Jordan VC. The estrogen receptor: a model for molecular medicine. Clin Cancer Res 2003; 9: 1980-1989
  • 22 Bosland MC, Mahmoud AM. Hormones and prostate carcinogenesis: Androgens and estrogens. J Carcinog 2011; 10: 33
  • 23 Nathan L, Shi W, Dinh H, Mukherjee TK, Wang X, Lusis AJ, Chaudhuri G. Testosterone inhibits early atherogenesis by conversion to estradiol: critical role of aromatase. Proc Natl Acad Sci USA 2001; 98: 3589-3593
  • 24 Akishita M, Hashimoto M, Ohike Y, Ogawa S, Iijima K, Eto M, Ouchi Y. Low testosterone level as a predictor of cardiovascular events in Japanese men with coronary risk factors. Atherosclerosis 2010; 210: 232-236
  • 25 Hayward CS, Kelly RP, Collins P. The roles of gender, the menopause and hormone replacement on cardiovascular function. Cardiovasc Res 2000; 46: 28-49
  • 26 Faulds MH, Zhao C, Dahlman-Wright K, Gustafsson JA. The diversity of sex steroid action: regulation of metabolism by estrogen signaling. J Endocrinol 2012; 212: 3-12
  • 27 Murphy E. Estrogen signaling and cardiovascular disease. Circ Res 2011; 109: 687-696
  • 28 Sudar E, Velebit J, Gluvic Z, Zakula Z, Lazic E, Vuksanovic-Topic L, Putnikovic B, Neskovic A, Isenovic ER. Hypothetical mechanism of sodium pump regulation by estradiol under primary hypertension. J Theor Biol 2008; 251: 584-592
  • 29 Isenovic E, Walsh MF, Muniyappa R, Bard M, Diglio CA, Sowers JR. Phosphatidylinositol 3-kinase may mediate isoproterenol-induced vascular relaxation in part through nitric oxid production. Metabolism 2002; 51: 380-386
  • 30 Maggiolini M, Picard D. The unfolding stories of GPR30, a new membrane-bound estrogen receptor. J Endocrinol 2010; 204: 105-114
  • 31 Carreau S, Bouraima-Lelong H, Delalande C. Estrogen, a female hormone involved in spermatogenesis. Adv Med Sci 2012; 57: 31-36
  • 32 Vina J, Sastre J, Pallardo FV, Gambini J, Borras C. Role of mitochondrial oxidative stress to explain the different longevity between genders: protective effect of estrogens. Free Radic Res 2006; 40: 1359-1365
  • 33 Li Y, Wang JP, Santen RJ, Kim TH, Park H, Fan P, Yue W. Estrogen stimulation of cell migration involves multiple signaling pathway interactions. Endocrinology 2010; 151: 5146-5156
  • 34 Simoncini T. Mechanisms of action of estrogen receptors in vascular cells: relevance for menopause and aging. Climacteric 2009; 12 (Suppl. 01) 6-11
  • 35 Fu XD, Simoncini T. Extra-nuclear signaling of estrogen receptors. IUBMB Life 2008; 60: 502-510
  • 36 Mendelsohn ME. Protective effects of estrogen on the cardiovascular system. Am J Cardiol 2002; 89: 12E-17E discussion 17E–18E
  • 37 Blum A, Koh K, Cannon 3rd RO. CME Paper: Hormone Replacement Therapy for Prevention or Treatment of Atherosclerosis in Postmenopausal Women: Promises, Controversies, and Clinical Trials. Am J Geriatr Cardiol 2000; 9: 81-88
  • 38 Koricanac G, Tepavcevic S, Zakula Z, Milosavljevic T, Stojiljkovic M, Isenovic ER. Interference between insulin and estradiol signaling pathways in the regulation of cardiac eNOS and Na(+)/K (+) -ATPase. Eur J Pharmacol 2011; 655: 23-30
  • 39 Haas E, Bhattacharya I, Brailoiu E, Damjanovic M, Brailoiu GC, Gao X, Mueller-Guerre L, Marjon NA, Gut A, Minotti R, Meyer MR, Amann K, Ammann E, Perez-Dominguez A, Genoni M, Clegg DJ, Dun NJ, Resta TC, Prossnitz ER, Barton M. Regulatory role of G protein-coupled estrogen receptor for vascular function and obesity. Circ Res 2009; 104: 288-291
  • 40 Seok YM, Jang EJ, Reiser O, Hager M, Kim IK. 17beta-Estradiol induces vasorelaxation in a G-protein-coupled receptor 30-independent manner. Naunyn Schmiedebergs Arch Pharmacol 2012; 385: 945-948
  • 41 Weil BR, Manukyan MC, Herrmann JL, Wang Y, Abarbanell AM, Poynter JA, Meldrum DR. Signaling via GPR30 protects the myocardium from ischemia/reperfusion injury. Surgery 2010; 148: 436-443
  • 42 Lindsey SH, Carver KA, Prossnitz ER, Chappell MC. Vasodilation in response to the GPR30 agonist G-1 is not different from estradiol in the mRen2.Lewis female rat. J Cardiovasc Pharmacol 2011; 57: 598-603
  • 43 Broughton BR, Miller AA, Sobey CG. Endothelium-dependent relaxation by G protein-coupled receptor 30 agonists in rat carotid arteries. Am J Physiol Heart Circ Physiol 2010; 298: H1055-H1061
  • 44 Rowlands DJ, Chapple S, Siow RC, Mann GE. Equol-stimulated mitochondrial reactive oxygen species activate endothelial nitric oxide synthase and redox signaling in endothelial cells: roles for F-actin and GPR30. Hypertension 2011; 57: 833-840
  • 45 Deschamps AM, Murphy E, Sun J. Estrogen receptor activation and cardioprotection in ischemia reperfusion injury. Trends Cardiovasc Med 2010; 20: 73-78
  • 46 Ullrich ND, Krust A, Collins P, MacLeod KT. Genomic deletion of estrogen receptors ERalpha and ERbeta does not alter estrogen-mediated inhibition of Ca2+ influx and contraction in murine cardiomyocytes. Am J Physiol Heart Circ Physiol 2008; 294: H2421-H2427
  • 47 Thomas P, Pang Y, Filardo EJ, Dong J. Identity of an estrogen membrane receptor coupled to a G protein in human breast cancer cells. Endocrinology 2005; 146: 624-632
  • 48 Meyer MR, Baretella O, Prossnitz ER, Barton M. Dilation of epicardial coronary arteries by the G protein-coupled estrogen receptor agonists G-1 and ICI 182,780. Pharmacology 2010; 86: 58-64
  • 49 Mercier I, Mader S, Calderone A. Tamoxifen and ICI 182,780 negatively influenced cardiac cell growth via an estrogen receptor-independent mechanism. Cardiovasc Res 2003; 59: 883-892
  • 50 Meyer MR, Haas E, Prossnitz ER, Barton M. Non-genomic regulation of vascular cell function and growth by estrogen. Mol Cell Endocrinol 2009; 308: 9-16
  • 51 Dubey RK, Jackson EK. Estrogen-induced cardiorenal protection: potential cellular, biochemical, and molecular mechanisms. Am J Physiol Renal Physiol 2001; 280: F365-F388
  • 52 Du XJ. Clues to understanding the role of estrogen receptors in mediating cardiovascular protection. Cardiovasc Res 2002; 56: 4-7
  • 53 Muchmore DB. Raloxifene: A selective estrogen receptor modulator (SERM) with multiple target system effects. Oncologist 2000; 5: 388-392
  • 54 Draper MW. The role of selective estrogen receptor modulators (SERMs) in postmenopausal health. Ann N Y Acad Sci 2003; 997: 373-377
  • 55 Walsh BW, Kuller LH, Wild RA, Paul S, Farmer M, Lawrence JB, Shah AS, Anderson PW. Effects of raloxifene on serum lipids and coagulation factors in healthy postmenopausal women. JAMA 1998; 279: 1445-1451
  • 56 Love RR, Newcomb PA, Wiebe DA, Surawicz TS, Jordan VC, Carbone PP, DeMets DL. Effects of tamoxifen therapy on lipid and lipoprotein levels in postmenopausal patients with node-negative breast cancer. J Natl Cancer Inst 1990; 82: 1327-1332
  • 57 Vogelvang TE, van der Mooren MJ, Mijatovic V. Hormone replacement therapy, selective estrogen receptor modulators, and tissue-specific compounds: cardiovascular effects and clinical implications. Treat Endocrinol 2004; 3: 105-115
  • 58 Gallino A, Stuber M, Crea F, Falk E, Corti R, Lekakis J, Schwitter J, Camici P, Gaemperli O, Di Valentino M, Prior J, Garcia-Garcia HM, Vlachopoulos C, Cosentino F, Windecker S, Pedrazzini G, Conti R, Mach F, De Caterina R, Libby P. “In vivo” imaging of atherosclerosis. Atherosclerosis 2012; 224: 25-36
  • 59 Glass CK, Witztum JL. Atherosclerosis. The road ahead. Cell 2001; 104: 503-516
  • 60 Fuster JJ, Fernandez P, Gonzalez-Navarro H, Silvestre C, Nabah YN, Andres V. Control of cell proliferation in atherosclerosis: insights from animal models and human studies. Cardiovascular research 2010; 86: 254-264
  • 61 Koh KK. Effects of estrogen on the vascular wall: vasomotor function and inflammation. Cardiovasc Res 2002; 55: 714-726
  • 62 Soskic SS, Sudar EM, Obradovic MM, Nikolic DM, Zarić BL, Stojanovic SD, Stokic EJ, Mikhailidis DP, Isenovic ER. The peroxisome proliferator-activated receptors and atherosclerosis. Angiology 2011; 62: 523-534
  • 63 Popovic M, Smiljanic K, Dobutovic B, Syrovets T, Simmet T, Isenovic ER. Thrombin and vascular inflammation. Mol Cell Biochem 2012; 359: 301-313
  • 64 Kzhyshkowska J, Neyen C, Gordon S. Role of macrophage scavenger receptors in atherosclerosis. Immunobiology 2012; 217: 492-502
  • 65 Liu PY, Death AK, Handelsman DJ. Androgens and cardiovascular disease. Endocrine Rev 2003; 24: 313-340
  • 66 Hayashi T, Sumi D, Juliet PA, Matsui-Hirai H, Asai-Tanaka Y, Kano H, Fukatsu A, Tsunekawa T, Miyazaki A, Iguchi A, Ignarro LJ. Gene transfer of endothelial NO synthase, but not eNOS plus inducible NOS, regressed atherosclerosis in rabbits. Cardiovasc Res 2004; 61: 339-351
  • 67 Reinehr T, Andler W. Changes in the atherogenic risk factor profile according to degree of weight loss. Arch Dis Child 2004; 89: 419-422
  • 68 Kuvin JT, Ramet ME, Patel AR, Pandian NG, Mendelsohn ME, Karas RH. A novel mechanism for the beneficial vascular effects of high-density lipoprotein cholesterol: enhanced vasorelaxation and increased endothelial nitric oxide synthase expression. Am Heart J 2002; 144: 165-172
  • 69 Banach M, Rizzo M, Obradovic M, Montalto G, Rysz J, Mikhailidis DP, Isenovic ER. PCSK9 Inhibition – A Novel Mechanism to Treat Lipid Disorders?. Curr Pharm Des 2012; [Epub ahead of print]
  • 70 Tabas I, Williams KJ, Boren J. Subendothelial lipoprotein retention as the initiating process in atherosclerosis: update and therapeutic implications. Circulation 2007; 116: 1832-1844
  • 71 Brunelli R, Greco G, Barteri M, Krasnowska EK, Mei G, Natella F, Pala A, Rotella S, Ursini F, Zichella L, Parasassi T. One site on the apoB-100 specifically binds 17-beta-estradiol and regulates the overall structure of LDL. FASEB J 2003; 17: 2127-2129
  • 72 Liang YQ, Akishita M, Kim S, Ako J, Hashimoto M, Iijima K, Ohike Y, Watanabe T, Sudoh N, Toba K, Yoshizumi M, Ouchi Y. Estrogen receptor beta is involved in the anorectic action of estrogen. Int J Obes Relat Metab Disord 2002; 26: 1103-1109
  • 73 Lijnen HR. Murine models of obesity and hormonal therapy. Thromb Res 2011; 127 (Suppl. 03) S17-S20
  • 74 Parhofer KG. Beyond LDL-cholesterol: HDL-cholesterol as a target for atherosclerosis prevention. Exp Clin Endocrinol Diabetes 2005; 113: 414-417
  • 75 Walsh BA, Mullick AE, Banka CE, Rutledge JC. 17beta-estradiol acts separately on the LDL particle and artery wall to reduce LDL accumulation. J Lipid Res 2000; 41: 134-141
  • 76 Simprini LA, Villines TC, Rich M, Taylor AJ. The relationship between subclinical atherosclerosis, non-high-density lipoprotein cholesterol, exercise, and diet among male participants of the PACC Project. Journal of clinical lipidology 2012; 6: 174-179
  • 77 Robinson JG, Wang S, Smith BJ, Jacobson TA. Meta-analysis of the relationship between non-high-density lipoprotein cholesterol reduction and coronary heart disease risk. J Am Coll Cardiol 2009; 53: 316-322
  • 78 Sniderman AD, Williams K, Contois JH, Monroe HM, McQueen MJ, de Graaf J, Furberg CD. A meta-analysis of low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B as markers of cardiovascular risk. Circ Cardiovasc Qual Outcomes 2011; 4: 337-345
  • 79 Pande RL. Approach to lipid therapy in the patient with atherosclerotic vascular disease. Curr Treat Opt Cardiovasc Med 2012; 14: 177-183
  • 80 Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 2001; 104: 2746-2753
  • 81 Dubey RK, Imthurn B, Barton M, Jackson EK. Vascular consequences of menopause and hormone therapy: importance of timing of treatment and type of estrogen. Cardiovasc Res 2005; 66: 295-306
  • 82 McGill Jr HC, McMahan CA, Herderick EE, Zieske AW, Malcom GT, Tracy RE, Strong JP. Obesity accelerates the progression of coronary atherosclerosis in young men. Circulation 2002; 105: 2712-2718
  • 83 Murase T, Hattori T, Ohtake M, Nakashima C, Takatsu M, Murohara T, Nagata K. Effects of estrogen on cardiovascular injury in ovariectomized female DahlS.Z-Lepr(fa)/Lepr(fa) rats as a new animal model of metabolic syndrome. Hypertension 2012; 59: 694-704
  • 84 Hodgin JB, Krege JH, Reddick RL, Korach KS, Smithies O, Maeda N. Estrogen receptor alpha is a major mediator of 17beta-estradiol’s atheroprotective effects on lesion size in Apoe-/- mice. J Clin Invest 2001; 107: 333-340
  • 85 Christian RC, Liu PY, Harrington S, Ruan M, Miller VM, Fitzpatrick LA. Intimal estrogen receptor (ER)beta, but not ERalpha expression, is correlated with coronary calcification and atherosclerosis in pre- and postmenopausal women. J Clin Endocrinol Metab 2006; 91: 2713-2720
  • 86 Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, Jackson RD, Beresford SA, Howard BV, Johnson KC, Kotchen JM, Ockene J. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 2002; 288: 321-333
  • 87 Oparil S, Levine RL, Chen SJ, Durand J, Chen YF. Sexually dimorphic response of the balloon-injured rat carotid artery to hormone treatment. Circulation 1997; 95: 1301-1307
  • 88 Cho JJ, Cadet P, Salamon E, Mantione K, Stefano GB. The nongenomic protective effects of estrogen on the male cardiovascular system: clinical and therapeutic implications in aging men. Med Sci Monit 2003; 9: RA63-RA68
  • 89 Clarkson TB. Estrogen effects on arteries vary with stage of reproductive life and extent of subclinical atherosclerosis progression. Menopause 2007; 14: 373-384
  • 90 McMahan CA, Gidding SS, Fayad ZA, Zieske AW, Malcom GT, Tracy RE, Strong JP, McGill Jr HC. Risk scores predict atherosclerotic lesions in young people. Arch Intern Med 2005; 165: 883-890
  • 91 Meyer MR, Haas E, Barton M. Gender differences of cardiovascular disease: new perspectives for estrogen receptor signaling. Hypertension 2006; 47: 1019-1026
  • 92 Bairey Merz CN, Johnson BD, Sharaf BL, Bittner V, Berga SL, Braunstein GD, Hodgson TK, Matthews KA, Pepine CJ, Reis SE, Reichek N, Rogers WJ, Pohost GM, Kelsey SF, Sopko G. Hypoestrogenemia of hypothalamic origin and coronary artery disease in premenopausal women: a report from the NHLBI-sponsored WISE study. J Am Coll Cardiol 2003; 41: 413-419
  • 93 Kaplan JR, Manuck SB, Anthony MS, Clarkson TB. Premenopausal social status and hormone exposure predict postmenopausal atherosclerosis in female monkeys. Obstet Gynecol 2002; 99: 381-388
  • 94 Abbey M, Owen A, Suzakawa M, Roach P, Nestel PJ. Effects of menopause and hormone replacement therapy on plasma lipids, lipoproteins and LDL-receptor activity. Maturitas 1999; 33: 259-269
  • 95 Rizzo M, Berneis K, Blanche PJ, Superko RH, Krauss RM. Effects of combined estrogen+progestin hormone therapy on hepatic lipase and lipoprotein lipase levels. Book of Abstract, 75th EAS Congress 2005 W16-P-075, p.120
  • 96 Mikhailidis DP, Elisaf M, Rizzo M, Berneis K, Griffin B, Zambon A, Athyros V, de Graaf J, Marz W, Parhofer KG, Rini GB, Spinas GA, Tomkin GH, Tselepis AD, Wierzbicki AS, Winkler K, Florentin M, Liberopoulos E. “European panel on low density lipoprotein (LDL) subclasses”: a statement on the pathophysiology, atherogenicity and clinical significance of LDL subclasses: executive summary. Curr Vasc Pharmacol 2011; 9: 531-532
  • 97 Villablanca AC, Tenwolde A, Lee M, Huck M, Mumenthaler S, Rutledge JC. 17beta-estradiol prevents early-stage atherosclerosis in estrogen receptor-alpha deficient female mice. J Cardiovasc Transl Res 2009; 2: 289-299
  • 98 Williams JK, Suparto I. Hormone replacement therapy and cardiovascular disease: lessons from a monkey model of postmenopausal women. ILAR J 2004; 45: 139-146
  • 99 Schwenke DC, Wagner JD, Adams MR. In vitro lipid peroxidation of LDL from postmenopausal cynomolgus macaques treated with female hormones. J Lipid Res 1999; 40: 235-244
  • 100 Mendelsohn ME, Karas RH. The protective effects of estrogen on the cardiovascular system. N Engl J Med 1999; 340: 1801-1811
  • 101 Farhat MY, Lavigne MC, Ramwell PW. The vascular protective effects of estrogen. FASEB J 1996; 10: 615-624
  • 102 Khalil RA. Sex hormones as potential modulators of vascular function in hypertension. Hypertension 2005; 46: 249-254