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An In Vivo Estrogen Deficiency Mouse Model for Screening Exogenous Estrogen Treatments of Cardiovascular Dysfunction After Menopause
06:18

An In Vivo Estrogen Deficiency Mouse Model for Screening Exogenous Estrogen Treatments of Cardiovascular Dysfunction After Menopause

Published on: August 13, 2019

Estrogens, autoimmunity and the heart

M Cutolo1, A Sulli, B Seriolo

  • 1Research Laboratory, Division of Rheumatology, Department of Internal Medicine, University of Genova, Italy. mcutolo@unige.it

Lupus
|October 13, 2005
PubMed

Insights

Hormone replacement therapy (HRT) with estrogens does not reduce cardiovascular risk in postmenopausal women and may worsen inflammation in autoimmune rheumatic diseases. Estrogen metabolites may explain these complex effects.

Area of Science:

  • Rheumatology
  • Cardiology
  • Endocrinology

Background:

  • Systemic autoimmune rheumatic diseases increase atherosclerosis and cardiovascular disease risk.
  • Proposed mechanisms include lipid abnormalities, oxidative stress, and inflammation.
  • Previous beliefs in estrogen's cardioprotective effects are challenged by recent trials.

Purpose of the Study:

  • To investigate the role of hormone replacement therapy (HRT) in cardiovascular risk for postmenopausal women.
  • To explore the complex relationship between estrogen, inflammation, and cardiovascular outcomes in rheumatic diseases.

Main Methods:

  • Review of recent randomized trials on HRT and cardiovascular outcomes.
  • Analysis of proposed mechanisms linking estrogen, inflammation, and atherosclerosis.
  • Consideration of estrogen peripheral metabolites' roles.

Main Results:

  • Recent randomized trials failed to demonstrate cardiovascular risk reduction with HRT in postmenopausal women.
  • Estrogen may have an adverse, dose-related effect on inflammation, particularly in autoimmune conditions.
  • Discrepancies between observational and randomized data may be linked to estrogen's inflammatory effects.

Conclusions:

  • HRT's cardioprotective potential is questionable, especially in postmenopausal women.
  • Estrogen may exacerbate inflammation in autoimmune rheumatic diseases, counteracting potential benefits.
  • Estrogen metabolites might offer new insights into these conflicting cardiovascular findings.

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