Estrogen and ischemic heart disease in females

Introduction: Although ischemic heart disease (IHD) develops in both genders under the influence of the same risk factors, it is much less frequent among female population, which is mostly assigned to favorable effects of estrogen. Objective: Since latest investigations have pointed to higher incidence of disease in female population, the objective of our study was to examine the relation between estrogen and other clinical and biochemical parameters significant for its manifestation. Method: The relation between estrogen levels and frequency of obesity, diabetes, hypertension as well as the levels of total, HDL, LDL i VLDL cholesterol, triglycerides, Lp(a), apoprotein A i B i PAI-1 was analyzed in 50 (25 pre- and postmenopausal) patients, treated due to IHD in the Health Center, Krusevac, in 2002 year. Results: Low concentration of estrogen was found in 22 (44%) patients. In addition, frequency of diabetes, obesity and risky levels of high atherogenic lipid fractions (total and LDL cholesterol, Lp(a), apoprotein B) was insignificantly higher, whereas the concentrations of PAI 1, triglycerides and HDL cholesterol were lower, with significant correlation between estrogen level and PAI-1 (T=0.32, p<0.05). Conclusion: Despite all past investigations, numerous questions related to high incidence of IHD among premenopausal women, have remained open - whether it occurs as a consequence of reduced estrogen synthesis, lower expression of estrogen receptors, their modified function or maybe concomitant influence of other risk factors, not necessarily connected with sex, that eliminate protective effects of this hormone.