Estrogen and cardiovascular risk in menopausal women

June 11, 2012

Women are less prone to cardiovascular disease then men; but this difference between the sexes becomes less marked after the menopause. This observation is behind a great deal of received wisdom, where oestrogen is assumed to have a beneficial effect on the heart and blood vessels. Today, new data seems to question these presuppositions. A study has been conducted by a team of Inserm researchers, directed by Pierre-Yves Scarabin (Inserm Unit 1018 "Centre for Epidemiology and Population Health Research"), on 6,000 women aged over 65; its results demonstrate, for the first time, that women with high levels of oestradiol in their blood are exposed to a greater risk of myocardial infarction or strokes.

The results are published in the Journal of the .

Oestrogen hormones play a key role in and reproduction in women. Oestradiol is the most active hormone. Its blood levels are particularly high during the active reproductive period. After the menopause, the ovarian function ceases, leading to a significant drop in oestrogen levels in the blood (the adipose tissue then becomes the main source of oestrogen). However, low concentrations of these hormones do continue to circulate and may still exert biological actions.

Throughout their lives, women are less exposed to the risk of cardiovascular disease than men. For many years, this relative immunity displayed by women was attributed to oestrogen undertaking a 'protector' role in terms of atherosclerosis and its complications. However, this hypothesis was not confirmed by recent research into the of the menopause. Oestrogen administration does not prevent ischaemic in and could even have a harmful effect on women in the highest age bracket.

Until now, no study has been able to clearly identify the link between circulating endogenous sexual hormones and the cardiovascular risk in menopausal women.

Today, this has been reduced by the results of a French cohort study (Three City Study-3C) performed on approximately 6,000 women aged over 65 from among the general public. Oestradiol levels in the blood were measured upon entry into the cohort and, after monitoring performed over a four year period, 150 new cases of cardiovascular disease had appeared.

For the first time, the results demonstrate that high oestrodial levels in the blood lead to an increased risk of or strokes, although the cause and effect link is not shown. This relation is not influenced by other known factors for , namely diabetes and obesity.

Other results show that oestrogen seems to affect some mechanisms involved arterial obstruction, which causes cardiovascular disease. Although the coagulative effect of oestrogen is clearly defined, significant research is now required to establish its role in the inflammatory process, particularly in obese women, where the accumulation of adipose tissues is associated with high oestrogen levels.

This new data questions the beneficial role of oestrogen on the heart and vessels. "Fresh studies must confirm this harmful effect and establish whether these results can be applied to younger menopausal women" stated Pierre-Yves Scarabin.

Explore further: New research explains how estrogen could help protect women from cardiovascular disease

More information: High Level of Plasma Estradiol as a New Predictor of Ischemic Arterial Disease in Older Postmenopausal Women: The Three-City Cohort Study, J Am Heart Assoc, dx.doi.org/D10.1161/JAHA.112.001388

Related Stories

New research explains how estrogen could help protect women from cardiovascular disease

August 11, 2011
The sex hormone oestrogen could help protect women from cardiovascular disease by keeping the body's immune system in check, new research from Queen Mary, University of London has revealed.

Estrogen treatment with no side-effects in sight

April 11, 2011
Oestrogen treatment for osteoporosis has often been associated with serious side-effects. Researchers at the Sahlgrenska Academy, University of Gothenburg, Sweden, have now, in mice, found a way of utilising the positive ...

The contraceptive pill and HRT may protect against cerebral aneurysm

May 5, 2011
Women who develop cerebral aneurysms are less likely to have taken the oral contraceptive pill or hormone replacement therapy, suggesting taking oestrogen could have a protective effect, reveals research published in the ...

Estrogen-only HRT continues to protect women against breast cancer long after they have stopped

March 6, 2012
Women who use the oestrogen-only form of hormone replacement therapy (HRT) appear less likely to develop breast cancer in the longer term, according to new research published Online First in The Lancet Oncology. A follow-up ...

Recommended for you

Hormone therapy in the menopause transition did not increase stroke risk

November 24, 2017
Postmenopausal hormone therapy is not associated with increased risk of stroke, provided that it is started early, according to a report from Karolinska Institutet published in the journal PLOS Medicine.

Low-salt and heart-healthy dash diet as effective as drugs for some adults with high blood pressure

November 22, 2017
A study of more than 400 adults with prehypertension, or stage 1 high blood pressure, found that combining a low-salt diet with the heart-healthy DASH diet substantially lowers systolic blood pressure—the top number in ...

Stroke patients may have more time to get treatment, study finds

November 22, 2017
Patients and doctors long have relied on a simple rule of thumb for seeking care after an ischemic stroke: "Time is brain."

Cases of heart failure continue to rise; poorest people worst affected

November 22, 2017
The number of people being diagnosed with heart failure in the UK continues to rise as a result of demographic changes common to many developed countries, new research by The George Institute for Global Health at the University ...

Some cancer therapies may provide a new way to treat high blood pressure

November 20, 2017
Drugs designed to halt cancer growth may offer a new way to control high blood pressure (hypertension), say Georgetown University Medical Center investigators. The finding could offer a real advance in hypertension treatment ...

Could this protein protect people against coronary artery disease?

November 17, 2017
The buildup of plaque in the heart's arteries is an unfortunate part of aging. But by studying the genetic makeup of people who maintain clear arteries into old age, researchers led by UNC's Jonathan Schisler, PhD, have identified ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.