Estrogens and the cardiovascular system: role of estradiol metabolites in hormone replacement therapy.

Estrogen substitution in the postmenopause reduces cardiovascular disease by means of direct and indirect effects of estradiol on the cardiovascular system. Recently, there have been increased indications that estradiol metabolites can also have beneficial effects. In the present short review, the existing experimental data for effects of estradiol metabolites on the blood vessels have been compiled. Results of our own studies, together with those of other research groups, indicate that particularly the catechol estrogens are able to exert a positive influence on the cardiovascular system, and may perhaps play a physiological role there. Attention is drawn to clinical-pharmacological aspects for use of estradiol metabolites for the prevention and treatment of cardiovascular disease.