Address for correspondence: Richard O. Cannon III, M.D., National Institutes of Health, Building 10, Room 7B15, 10 Center Drive MSC-1650, Bethesda, MD 20892-1650. Voice: 301-496-9895; fax: 301-402-0888.
cannonr{at}nih.gov
Epidemiological observations, clinical mechanistic studies,
and basic laboratory research suggest that estrogen therapy
is associated with beneficial cardiovascular effects in postmenopausal
women. Estrogen has a multitude of biological effects that may
account for this apparent benefit (which remains to be proved
in randomized clinical trials), including favorable effects
on the lipid profile, increased endothelial nitric oxide bioactivity,
and enhanced fibrinolysis. However, long-term estrogen therapy
increases the risk of breast and endometrial cancers. Raloxifene,
a benzothiophene derivative that binds to the estrogen receptor,
is a selective estrogen receptor modulator, producing estrogen-agonist
effects in some tissues (liver, bone) and estrogen-antagonistic
effects in others (breast, uterus), and may prove to be an option
for women with atherosclerosis or its risk factors. This review
updates the current knowledge of the biological effects of selective
estrogen receptor modulators of potential cardiovascular importance
in postmenopausal women.
