Total Estrogen Time and Obstructive Coronary Disease in Women: Insights from the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE)

Merz, C. Noel Bairey; Johnson, B. Delia; Berga, Sarah L.; Braunstein, Glenn D.; Azziz, Ricardo; Yang, Yuching; Reis, Steven E.; Bittner, Vera; Hodgson, T. Keta; Pepine, Carl J.; Sharaf, Barry L.; Sopko, George; Kelsey, Sheryl F.

doi:10.1089/jwh.2008.1063

Cited by 31 publications

(19 citation statements)

References 33 publications

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“…In addition, endogenous estradiol levels did not differ between women with coronary heart disease history and the control group, and the same was demonstrated in women undergoing carotid artery endarterectomy [16,17]. In the same direction, estrogen exposure time was not related to coronary artery disease in postmenopausal women with suspected ischaemia [18].…”

Section: Discussionmentioning

confidence: 91%

Estradiol levels predict short‐term adverse health outcomes in postmenopausal acute stroke women

Παππά

Vemmos

Mantzou

et al. 2012

Euro J of Neurology

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Section: Discussionmentioning

confidence: 91%

Estradiol levels predict short‐term adverse health outcomes in postmenopausal acute stroke women

Παππά

Vemmos

Mantzou

et al. 2012

Euro J of Neurology

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“…Consistent with those findings, in postmenopausal women undergoing coronary angiography, strong inverse relationships were observed between years of menopausal hormone treatment exposure and both the degree of stenosis and the severity score. 51 …”

Section: Interpretation and Perspectivementioning

confidence: 99%

Timing and Duration of Menopausal Hormone Treatment May Affect Cardiovascular Outcomes

Harman

Vittinghoff²,

Brinton

et al. 2011

The American Journal of Medicine

101

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Largely on the basis of the first publication of findings of net harm with menopausal hormone treatment in the Women’s Health Initiative (WHI) hormone trials, current Food and Drug Administration recommendations limit menopausal hormone treatment to the “… shortest duration consistent with treatment goals …,” with goals generally taken to mean relief of menopausal symptoms and maximal duration as approximately 5 years. The WHI finding of net harm was due largely to the absence of beneficial effects on coronary heart disease incidence rates. Published analyses of WHI data by age or time since menopause find that excess coronary heart disease risk with menopausal hormone treatment is confined to more remotely menopausal or older women, with younger women showing nonsignificant trends toward benefit (the “timing hypothesis”). Moreover, a recently published reexamination of data from the WHI Estrogen plus Progestin trial suggests that reduced coronary heart disease risk may appear only after 5 to 6 years of treatment. Consistent with this finding, risk ratios for coronary heart disease were calculated as 1.08 (95% confidence interval, 0.86–1.36) in years 1 to 6 and as 0.46 (confidence interval, 0.28–0.78) in years 7 to 8+ in the WHI Estrogen Alone trial. Previous studies also support the beneficial effects of menopausal hormone treatment after prolonged exposure. Thus, current analyses do not support a generalized recommendation for short duration of menopausal hormone treatment. Rather, they suggest that current Food and Drug Administration practice guidelines should be reconsidered to allow individualized care based on risk:benefit considerations. New research is urgently needed evaluating influences of timing, duration, dose, route of administration, and agents on menopausal hormone treatment-related risks and benefits to better understand how to optimize recommendations for individual patients.

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“…Estradiol may negatively impact an already unhealthy individual, but synergize other health-promoting behaviors such as good nutrition, exercise, and stress reduction in a relatively healthy individual [84]. Additionally, the mechanism of action of estrogen appears to be very complex and its protective role can not be attributable to the exposure duration alone [85].…”

Section: Estrogenmentioning

confidence: 99%

Glucose Transporters Regulation on Ischemic Brain: Possible Role as Therapeutic Target

Espinoza-Rojo¹,

Iturralde-Rodriguez²,

Chánez‐Cárdenas³

et al. 2010

CNSAMC

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Ischemic stroke is a major cause of death worldwide that provokes a high society cost. Deprivation of blood supply, with the subsequent deficiency of glucose and oxygen, triggers an important number of mechanisms (e.g. excitotoxicity, oxidative stress and inflammation) leading to irreversible neuronal injury. Consequently, ischemia increases the energy demand which is associated with profound changes in brain energy metabolism. Glucose transport activity may adapt to ensure the delivery of glucose to maintain normal cellular function, even at the low glucose levels observed in plasma during ischemia. In the brain, the main glucose transporters (GLUTs) are GLUT3 in neurons and GLUT1 in the microvascular endothelial cells of the blood brain barrier and glia. The intracellular signaling pathways involved in GLUT regulation in cerebral ischemia remain unclear; however, it has been established that ischemia induces changes in their expression. In this review, we describe the effect of glutamate-induced excitotoxicity, mitochondrial damage, glucose deprivation, and hypoxia on GLUTs expression in the brain. Additionally, we discuss the possible role of GLUTs as therapeutic target for ischemia. Despite of the intense research, current therapeutics options for stroke are very limited, therefore it is especially important to find new options. Few studies have examined the neuroprotective potential of GLUT up-regulation in ischemic stroke; however, evidence suggests that augmented GLUTs could be related to a protective mechanism. Increased understanding of the beneficial effects of GLUTs activation provides the rationale for targeting GLUT in the development of new therapeutic strategies.

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Total Estrogen Time and Obstructive Coronary Disease in Women: Insights from the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE)

Cited by 31 publications

References 33 publications

Estradiol levels predict short‐term adverse health outcomes in postmenopausal acute stroke women

Estradiol levels predict short‐term adverse health outcomes in postmenopausal acute stroke women

Timing and Duration of Menopausal Hormone Treatment May Affect Cardiovascular Outcomes

Glucose Transporters Regulation on Ischemic Brain: Possible Role as Therapeutic Target

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