Sex hormones and coronary disease: a review of the clinical studies.

摘要: PIP: A male to female ration of coronary disease 2:1 has been a consistent finding. This differential persists event when the classic risk factors for disease--hypertension, smoking, obesity, diabetes, and hyperlipidemia--are controlled gender. The most likely ultimate cause this phenomenon is male-female differences in sex hormone patterns. Clinical studies area have either compared profiles men women with without or computed relative prevalence populations that differ their In general, research findings disputed hypothesis persons low levels protective factor such as estrogen progesterone high testosterone. Coronary patients actually elevated testosterone levels; endogenous are normal before infarction but show stress-mediated increase immediate postinfarction period. Findings premenopausal women, loss protection after menopause, cirrhosis-related hyperestrogenemia suggest natural estrogens antiatherogenic. effect pregnancy against myocardial infarction, despite concomitant potentially thrombogenic at time, seems indicate progesterone, whose also extremely during pregnancy, plays major anti-infarction distinct from estrogen. Studies oral contraceptive (OC) users taking brief periods found these exogenous hormones produce thrombosis not atherosclerosis. Finally, finding increased long-term OC indicates synthetic favor atherosclerosis by suppressing production.