Effects of steroid hormones on vascular functions

The purpose of this review is to present reported findings of effects of steroids on vascular function and to discuss the biological significance in vascular physiology and pathology. Steroid hormones play various roles in vascular functions through the specific receptor localized in the endothelium and underlying vascular smooth muscle cells (VSMCs). Estrogen replacement therapy in postmenopausal women is in general associated with a reduction in mortality from cardiovascular disease and the beneficial effects of estrogens are caused by modulation of lipid metabolism, expression of leukocyte adhesion molecules, and migration of VSMCs in the vascular wall. Estrogens also play a role as vasodilators through an increment in nitric oxide (NO) production in endothelium or modulation of calcium homeostasis in VSMCs. Some progestin molecules partially oppose the effects of estrogens on vascular functions, but striking differences exist among the types of molecules. Testosterone shows a vasorelaxant response, but detailed actions of androgens on vascular functions remain unknown. Glucocorticoids act on vasoconstriction through reduced prostacyclin production, increased alpha-adrenoceptor numbers, and inhibition of NO synthase, while mineralocorticoids induce hypertrophy and hyperplasia of VSMCs and perivascular fibrosis and cause peripheral vascular resistance, in addition to changes in vascular electrocyte permeability. Some rapid actions of steroids are mediated by "nongenomic" responses in vascular tissues. Recent studies have also demonstrated that steroid-producing or -metabolizing enzymes are expressed in the vascular wall, suggesting the local regulation of steroids in the vascular system. Thus, steroid hormones greatly influence vascular functions and an understanding of the mechanisms may provide new means to prevent vascular diseases.