Maas A H, van Gilst W H, Verheugt F W
Isala klinieken, locatie Sophia, afd. Cardiologie, Dr. van Heesweg 2, 8025 AB Zwolle.
Ned Tijdschr Geneeskd. 2001 Jan 13;145(2):65-9.
Coronary heart disease develops on average 10-15 years later in women than in men and is uncommon before menopause. 17 beta-estradiol has atheroprotective properties through rapid vasodilatory effects on the endothelium by stimulating nitric monoxide production and longer-term actions by modulating changes in gene expression. Cardioprotective effects of hormone replacement therapy in postmenopausal women have been suggested by observational data but not proved in randomized trials. Recent data indicate that oestrogens have regenerative effects on the vascular wall after acute injury, like a percutaneous transluminal coronary angioplasty. As endothelial reactivity declines with age, more studies are needed to investigate the benefits of hormone replacement therapy in the younger category of postmenopausal women.
冠心病在女性中平均比男性晚10 - 15年发病，且在绝经前并不常见。17β - 雌二醇具有抗动脉粥样硬化特性，通过刺激一氧化氮生成对内皮产生快速血管舒张作用，并通过调节基因表达变化产生长期作用。观察性数据提示绝经后女性激素替代疗法具有心脏保护作用，但在随机试验中尚未得到证实。最近的数据表明，雌激素对急性损伤后的血管壁具有再生作用，如经皮腔内冠状动脉成形术后。随着内皮反应性随年龄下降，需要更多研究来探讨激素替代疗法对较年轻绝经后女性的益处。
