New insights into the pathophysiology of ischemic heart disease

Document Type

Journal Article

Publication Date

12-1-1995

Journal

Journal of Myocardial Ischemia

Volume

7

Issue

6

Abstract

Recent insights into the processes contributing to coronary artery disease (CAD) suggest new targets For diagnosis and therapeutic intervention. in particular, we now have a better understanding of the important roles that factors generated by the endothelium play in mediating vasoconstriction, thrombosis, smooth muscle cell (SMC) growth, and leukocyte recruitment. Many CAD risk factors, such as cigarette smoking, hypertension, and hypercholesterolemia, that can injure the endothelium and disrupt these important functions, are especially prevalent in women. Evidence suggests that the prominent vascular protective actions of estrogen may stem from (1) effects on endothelium, nitric oxide (NO), and oxidative metabolism; (2) a direct vasodilatory action on the arterial wall; (3) effects on the balance between endogenous Fibrinolysis and thrombosis; and/or (4) favorable alterations of lipid metabolism.

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