Gender differences in the regulation of vascular tone.

1. The greater incidence of hypertension and coronary artery disease in men and post-menopausal women compared with premenopausal women has suggested vascular protective effects of the female sex hormone oestrogen. However, vascular effects of the female sex hormone progesterone and the male sex hormone testosterone have also been suggested. 2. Oestrogen, progesterone and testosterone receptors have been identified in the plasmalemma, cytosol and nuclear compartments of vascular cells. The interaction of sex hormones with their specific receptors triggers not only long-term genomic vascular effects, but also acute non-genomic vascular responses. 3. Sex hormones may activate endothelium-dependent vascular relaxation pathways, including the nitric oxide-cGMP and prostacyclin-cAMP pathways and a hyperpolarizing factor pathway. 4. Sex hormones may also inhibit the mechanisms of vascular smooth muscle contraction, such as [Ca2+]i, protein kinase C and other protein kinases. 5. The sex hormone-induced stimulation of endothelium-dependent vascular relaxation and inhibition of vascular smooth muscle contraction may contribute to the gender differences in vascular tone and may represent potential beneficial vascular effects of hormone-replacement therapy during natural and surgically induced deficiencies of gonadal hormones.