SEX HORMONES AND VASCULAR PROTECTION IN WOMEN

描述：绝经后妇女患动脉粥样硬化的风险增加。 疾病和冠心病事件。然而，还需要进一步的资料。 关于雌激素和孕激素对 动脉粥样硬化 研究人员将应用最近的概念， 血管生物学检查性激素对血管的影响 在一系列临床研究中。 内皮细胞脱落- 依赖性血管舒张发生在动脉粥样硬化中。 调查人员 假设雌激素替代治疗可以改善 动脉粥样硬化后内皮依赖性血管舒张 更年期妇女 特别是雌激素和雌激素的长期影响 雌激素和孕激素对内皮依赖性 动脉粥样硬化性心外膜冠状动脉的动脉功能 绝经后妇女将在连续的心脏检查期间进行检查。 导尿 由于血管扩张功能障碍也发生在肢体 冠状动脉疾病患者的动脉， 这些研究包括对两者作用机制的研究， 雌激素和雌激素与孕激素对血管舒张功能的影响 使用超声和体积描记法测量肱动脉。 他们将 在前臂中探测EDRF（一氧化氮）通路 循环与乙酰胆碱和1-单甲基精氨酸，作用 血管活性前列腺素类与阿司匹林和血管收缩剂反应性 与苯肾上腺素和血管紧张素II。 由于雌激素似乎减少了 绝经后妇女的冠状动脉事件，初步证据表明， 内皮依赖性血管舒张的改善，他们建议测试 绝经后妇女的激素替代疗法 阻塞性冠状动脉疾病和活动性缺血患者 减少通过动态监测测量的缺血负荷。 这些 研究旨在更好地了解 性激素对局部动脉功能的有益作用， 动脉粥样硬化的妇女和发展知识的使用性 在安全剂量下为女性提供血管保护的激素 冠状动脉疾病

DESCRIPTION: Post-menopausal women are at increased risk for arterial disease and coronary events. However, further information is needed regarding the effects of estrogen and progesterone on the biology of atherosclerosis. The investigators will apply recent concepts regarding vascular biology to examine the effects of sex hormones on the vessel wall in a series of clinical studies. Abnormalities of endothelium- dependent vasodilation occur in atherosclerosis. The investigators hypothesize that estrogen replacement will improve the abnormal endothelium-dependent vasodilation in atherosclerotic arteries of post menopausal women. In particular, the long term effects of both estrogen and estrogen with progesterone on the loss of endothelium- dependent arterial function in atherosclerotic epicardial coronary arteries in postmenopausal women will be examined during sequential cardiac catheterizations. Since vasodilator dysfunction also occurs in limb arteries in patients with coronary artery disease, they will extend these studies to include studies of the mechanisms of action of both estrogen and estrogen with progesterone on vasodilator function in the brachial artery using ultrasonography and plethysmography. They will pharmacologically probe the EDRF (nitric oxide) pathway in the forearm circulation with acetylcholine and 1-monomethyl arginine, the role of vasoactive prostanoids with aspirin and vasoconstrictor responsiveness with phenylephrine and angiotensin II. Since estrogen appears to reduce coronary events in post menopausal women and preliminary evidence shows improvement in endothelium dependent vasodilation, they propose to test the hypothesis that hormone replacement therapy in post menopausal women with obstructive coronary disease and active ischemia can significantly reduce the ischemic burden as measured by ambulatory monitoring. These studies are designed to provide a better understanding of the mechanisms of the beneficial effects of sex hormones on local arterial functions in atherosclerosis in women and to develop knowledge of the use of sex hormones that will provide vascular protection at safe doses in women with coronary artery disease.