Mechanisms of cardioprotection by estrogens.

Strong scientific evidence suggests that estrogen therapy offers considerable protection from coronary artery disease. While earlier studies focused mainly on favorable changes in plasma lipid profiles as the mechanism of estrogen action, recent studies have documented other mechanisms of action including direct effects on vascular wall. The other mechanisms include estrogen's role as an antioxidant, its ability to protect from DNA damage, inhibition of cell proliferation, and altering vascular response to vasoactive agents. Considerable emphasis must be placed on research on individual components of the commonly used conjugated estrogens and estrogen structure/function relationship to target specific tissues and minimize undesirable effects while maintaining estrogen's cardioprotective potency.