Advertisement

Netherlands Heart Journal

, Volume 21, Issue 4, pp 175–180 | Cite as

Detrimental effects of endogenous oestrogens on primary acute myocardial infarction among postmenopausal women

  • M. Dong
  • F. Guo
  • J. Yang
  • S. Liu
  • Z. Tao
  • Y. Fang
  • C. Zhang
  • J. Li
  • G. LiEmail author
Original Article

Abstract

Objective

Traditionally, oestrogens were considered to be protective for the cardiovascular system for premenopausal women. Therefore, we conducted a retrospective case–control study to examine the association between endogenous oestrogens and acute myocardial infarction (AMI) risk among postmenopausal women.

Methods

A case–control study was performed among 30 primary AMI patients and 60 control subjects. Baseline characteristics data was collected and endogenous sex hormones levels were determined using chemoluminescence and radioimmunoassay methods. Conditional logistic regression models were developed with adjustment for confounders.

Results

Compared with controls, the circulating oestrone, oestradiol, androstenedione and testosterone levels were significantly higher in AMI patients (P < 0.05) while the sex hormone binding globulin (SHBG) level was lower (P < 0.05). Spearman correlation coefficients showed oestradiol was positively correlated with body mass index (BMI) and waist-to-hip ratio (WHR) in cases, but not in controls. In univariable conditional logistic regression models, oestrone, oestradiol, testosterone, WHR, BMI, diabetes and hypertension were all found to be positively associated with AMI (P < 0.05). After adjusting for these factors, oestradiol (odds ratio (OR) = 4.75; 95 % confidence interval (CI) = 1.07–21.10; P = 0.04) and WHR (OR = 6.46; 95 % CI = 1.09–38.39; P = 0.04) continued to demonstrate strong positive associations with AMI.

Conclusions

A higher level of oestradiol was potentially associated with primary AMI risk among postmenopausal women.

Keywords

Oestrogens Acute myocardial infarction Acute stress Adipose tissue Postmenopausal 

Notes

Acknowledgments

The authors have no conflict of interest regarding this work.

Authors’ statements and disclosure

We declare that no financial support (grants and funds) was received in this study. We further declare that there is no conflict of interest.

References

  1. 1.
    Maas AH, Appelman YE. Gender differences in coronary heart disease. Neth Heart J. 2010;18(12):598–603.CrossRefGoogle Scholar
  2. 2.
    Lipton JA, Can A, Akoudad S, et al. The role of insulin therapy and glucose normalisation in patients with acute coronary syndrome. Neth Heart J. 2011;19(2):79–84.CrossRefGoogle Scholar
  3. 3.
    Breet NJ, Sluman MA, van Berkel MA, et al. Effect of gender difference on platelet reactivity. Neth Heart J. 2011;19(11):451–7.CrossRefGoogle Scholar
  4. 4.
    Barrett-Connor E, Goodman-Gruen D. Prospective study of endogenous sex hormones and fatal cardiovascular disease in postmenopausal women. BMJ. 1995;311(7014):1193–6.CrossRefGoogle Scholar
  5. 5.
    Haffner SM, Moss SE, Klein BE, et al. Sex hormones and DHEA-SO4 in relation to ischemic heart disease mortality in diabetic subjects. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. Diabetes Care. 1996;19(10):1045–50.CrossRefGoogle Scholar
  6. 6.
    Mikulec KH, Holloway L, Krasnow RE, et al. Relationship of endogenous sex hormones to coronary heart disease: a twin study. J Clin Endocrinol Metab. 2004;89(3):1240–5.CrossRefGoogle Scholar
  7. 7.
    Arnlov J, Pencina MJ, Amin S, et al. Endogenous sex hormones and cardiovascular disease incidence in men. Ann Intern Med. 2006;145(3):176–84.CrossRefGoogle Scholar
  8. 8.
    Rexrode KM, Manson JE, Lee IM, et al. Sex hormone levels and risk of cardiovascular events in postmenopausal women. Circulation. 2003;108(14):1688–93.CrossRefGoogle Scholar
  9. 9.
    Thygesen K, Alpert JS, White HD. Universal definition of myocardial infarction. The Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction. J Am Coll Cardiol. 2007;50(22):2173–88.CrossRefGoogle Scholar
  10. 10.
    Reckelhoff JF. Sex steroids, cardiovascular disease, and hypertension: unanswered questions and some speculations. Hypertension. 2005;45(2):170–4.CrossRefGoogle Scholar
  11. 11.
    Hulley S, Grady D, Bush T, et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women: Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA. 1998;280(7):605–13.CrossRefGoogle Scholar
  12. 12.
    Herrington DM, Reboussin DM, Brosnihan KB, et al. Effects of estrogen replacement on the progression of coronary-artery atherosclerosis. N Engl J Med. 2000;343(8):522–9.CrossRefGoogle Scholar
  13. 13.
    Chen Y, Zeleniuch-Jacquotte A, Arslan AA, et al. Endogenous hormones and coronary heart disease in postmenopausal women. Atherosclerosis. 2011;216(2):414–9.CrossRefGoogle Scholar
  14. 14.
    Rivier C. Luteinizing-hormone-releasing hormone, gonadotropins, and gonadal steroids in stress. Ann N Y Acad Sci. 1995;771:187–91.CrossRefGoogle Scholar
  15. 15.
    Breen KM, Karsch FJ. Does cortisol inhibit pulsatile luteinizing hormone secretion at the hypothalamic or pituitary level? Endocrinology. 2004;145(2):692–8.CrossRefGoogle Scholar
  16. 16.
    Aksut SV, Aksut G, Karamehmetoglu A, et al. The determination of serum estradiol, testosterone and progesterone in acute myocardial infarction. Jpn Heart J. 1986;27(6):825–37.CrossRefGoogle Scholar
  17. 17.
    Sewdarsen M, Vythilingum S, Jialal I, et al. Abnormalities in sex hormones are a risk factor for premature manifestation of coronary artery disease in South African Indian men. Atherosclerosis. 1990;83(2–3):111–7.CrossRefGoogle Scholar
  18. 18.
    Wang C, Chan V, Tse TF, et al. Effect of acute myocardial infarction on pituitary-testicular function. Clin Endocrinol (Oxf). 1978;9(3):249–53.CrossRefGoogle Scholar
  19. 19.
    Woolf PD, Hamill RW, McDonald JV, et al. Transient hypogonadotrophic hypogonadism caused by critical illness. J Clin Endocrinol Metab. 1985;60(3):444–50.CrossRefGoogle Scholar
  20. 20.
    Smith GD, Ben Shlomo Y, Beswick A, et al. Cortisol, testosterone, and coronary heart disease: prospective evidence from the Caerphilly study. Circulation. 2005;112(3):332–40.CrossRefGoogle Scholar
  21. 21.
    Rosmond R, Wallerius S, Wanger P, et al. A 5-year follow-up study of disease incidence in men with an abnormal hormone pattern. J Intern Med. 2003;254(4):386–90.CrossRefGoogle Scholar
  22. 22.
    Baglietto L, English DR, Hopper JL, et al. Circulating steroid hormone concentrations in postmenopausal women in relation to body size and composition. Breast Cancer Res Treat. 2009;115(1):171–9.CrossRefGoogle Scholar
  23. 23.
    Vermeulen A, Verdonck L. Sex hormone concentrations in post-menopausal women. Clin Endocrinol (Oxf). 1978;9(1):59–66.CrossRefGoogle Scholar
  24. 24.
    Longcope C, Baker Jr R, Johnston CC. Androgen and estrogen metabolism: relationship to obesity. Metabolism. 1986;35(3):235–7.CrossRefGoogle Scholar
  25. 25.
    Hong Y, Yu B, Sherman M, et al. Molecular basis for the aromatization reaction and exemestane-mediated irreversible inhibition of human aromatase. Mol Endocrinol. 2007;21(2):401–14.CrossRefGoogle Scholar
  26. 26.
    Xu H, Barnes GT, Yang Q, et al. Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest. 2003;112(12):1821–30.CrossRefGoogle Scholar
  27. 27.
    Hosogai N, Fukuhara A, Oshima K, et al. Adipose tissue hypoxia in obesity and its impact on adipocytokine dysregulation. Diabetes. 2007;56(4):901–11.CrossRefGoogle Scholar
  28. 28.
    Purohit A, Newman SP, Reed MJ. The role of cytokines in regulating estrogen synthesis: implications for the etiology of breast cancer. Breast Cancer Res. 2002;4(2):65–9.CrossRefGoogle Scholar
  29. 29.
    Writing Group for Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. JAMA. 2002;288(3):321–33.CrossRefGoogle Scholar

Copyright information

© Springer Media / Bohn Stafleu van Loghum 2012

Authors and Affiliations

  • M. Dong
    • 1
  • F. Guo
    • 2
  • J. Yang
    • 1
  • S. Liu
    • 1
  • Z. Tao
    • 1
  • Y. Fang
    • 1
  • C. Zhang
    • 1
  • J. Li
    • 1
  • G. Li
    • 3
    Email author
  1. 1.Department of CardiologyYuhuangding HospitalYantai CityPeople’s Republic of China
  2. 2.Department of CardiologyYantaishan HospitalYantai CityPeople’s Republic of China
  3. 3.Department of Cardiology, Tianjin Institute of CardiologySecond Hospital of Tianjin Medical UniversityTianjinPeople’s Republic of China

Personalised recommendations