Protective effects of estrogen on the cardiovascular system

Am J Cardiol. 2002 Jun 20;89(12A):12E-17E; discussion 17E-18E. doi: 10.1016/s0002-9149(02)02405-0.


Estrogen has direct and indirect effects on the cardiovascular system that are mediated by the estrogen receptors ER-alpha and ER-beta. The direct effects of estrogen occur through rapid nongenomic and longer-term genomic pathways. The rapid effects of estrogen are mediated by ERs and result in the activation of endothelial nitric oxide synthase, leading to arterial vasodilation. Longer-term effects involve changes in gene and protein expression, modulating the response to injury and atherosclerosis. Estrogen also indirectly influences serum lipoprotein and triglyceride profiles, and the expression of coagulant and fibrinolytic proteins. Advanced atherosclerosis and certain progestins, however, may attenuate some of the protective effects of estrogen.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Cardiovascular System / drug effects*
  • Estrogen Replacement Therapy*
  • Estrogens / pharmacology*
  • Female
  • Humans
  • Hypercholesterolemia / complications
  • Hypercholesterolemia / prevention & control
  • Mice
  • Mice, Knockout
  • Nitric Oxide Synthase / metabolism
  • Receptors, Estrogen / drug effects
  • Receptors, Estrogen / physiology
  • Risk Factors
  • Vasodilation / drug effects


  • Estrogens
  • Receptors, Estrogen
  • Nitric Oxide Synthase