[Sex hormones, glycolipid metabolism, and atherogenesis]

The prevalence of coronary artery disease is lower in women than in men. Ovarian estrogen is believed to decrease the risk of coronary heart disease. Today, there is an increasing demand for estrogen replacement not only for amelioration of menopausal subjective symptoms but also for the prophylactic action of estrogen against osteoporosis in postmenopausal women. Is generally agreed that estrogen replacement therapy reduces cardiovascular morbidity and mortality in postmenopausal women. Estrogen replacement therapy may protect against coronary heart disease by altering plasma lipoprotein concentrations, by increasing HDL cholesterol and decreasing LDL cholesterol, and thereby inhibiting progression of coronary artery atherosclerosis. Oral contraceptive can induce deterioration in glucose tolerance that has consistently been associated with insulin excess and insulin resistance. This situation can increase the coronary heart disease risk. New findings suggest that there may be independent cardioprotective effects of estrogen, such a direct inhibitory influence on thrombosis, vasospasm or atherogenesis, inhibiting atherosclerotic plaque formation in arterial walls.