Testosterone pp 229-257 | Cite as

Androgens, cardiovascular risk factors and atherosclerosis

  • Arnold von Eckardstein


Atherosclerotic coronary, cerebral, and peripheral vessel diseases are the most frequent cause of death and disability in the industrialized countries for both men and women. Before menopause both morbidity and mortality is much lower in women than in men because of atherosclerotic vessel diseases. After menopause the incidence of atherosclerotic vessel diseases increases steeply ( and Utian 1994). In Germany, for example, before age of 65 four times as many as women die because of myocardial infarction (MI). After age 75, coronary heart disease (CHD) mortality is much higher in women than in men so that finally the overall cardiovascular mortality does not differ among sexes (Statistisches Bundesamt 1997). The approximately 10-year gap in the clinical manifestation of atherosclerotic vessel diseases between men and women is usually explained by the anti-atherogenic effects of estrogens. The anti- atherogenicity of estrogens is also indicated by the high incidence of cardiovascular disease in ovariectomized women who do not substitute estrogens, and by the lower cardiovascular event rates of postmenopausal women who take estrogens (Barrett-Connor and Bush 1991; Gorodeski and Utian 1994). In addition to these clinical studies, many animal studies also provided evidence for the anti-atherogenicity of estrogens (Bourassa et al. 1996; Bruck et al. 1997). Moreover, compared to men of the same age, premenopausal women have a more favourable cardiovascular risk factor profile with higher levels of high density lipoprotein cholesterol (HDL-C) and lower levels of low density lipoprotein cholesterol (LDL-C), lipoprotein(a) (Lp(a)), homocysteine, and fibrinogen.


Cardiovascular Risk Factor Cholesteryl Ester Polycystic Ovary Syndrome Cholesteryl Ester Transfer Protein Plasminogen Activator Inhibitor Type 
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© Springer-Verlag Berlin Heidelberg 1998

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  • Arnold von Eckardstein

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