Various actions of oestrogens on the vascular system.

Epidemiological studies show a reduction in cardiovascular disease with postmenopausal oestrogen use. Oestrogens have been shown to have both metabolic effects and direct effects on the vasculature, both of which may improve arterial function and reduce or reverse atheroma formation. The metabolic effects include changes in lipids and lipoproteins, glucose and insulin metabolism, coagulation and fibrinolysis. The direct arterial effects include changes in endothelium-dependent processes, ion channels, renin-angiotensin system and remodelling processes. The various actions of oestrogens on the vascular system are reviewed. It is clearly important to understand the biological basis of these effects of oestrogen on the cardiovascular system in order to optimize current and future hormone-replacement therapy in women after natural or surgical menopause.