Hormones and Cardiovascular Disease
Director: Pierre-Yves Scarabin

 

Hormones and Cardiovascular Disease
Director: Pierre-Yves Scarabin

 

Hormones and Cardiovascular Disease
Director: Pierre-Yves Scarabin

 

The relationship of endogenous sex hormone levels with incident cardiovascular disease was investigated among postmenopausal women participating in the Multi-Ethnic Study of Atherosclerosis (MESA). The results of this cohort study show that higher estradiol levels are associated with a lower risk of coronary heart disease. This finding contradicts the results of the Three-City study (3C) prospective study where high levels of endogenous estradiol have emerged as a new independent predictor of the risk of coronary heart disease and stroke among postmenopausal women older than 65 years. Major limitations raise concerns about the reliability of the MESA results. First, data analysis included seven hormonal variables combined with five clinical outcomes within three statistical adjustment models and no attempt was made to minimize the greatly increased probability of declaring false significances. Second, overadjustment for intermediate variables such as C-reactive protein, IL-6 and D-Dimer is questionable and may lead to spurious associations. The results of the MESA study suggesting beneficial effects of estrogens on vascular system among women closer to menopause may also be in line with the timing hypothesis. The age of women enrolled in the cohorts as well as their level of cardiovascular risk factor may therefore be a critical factor to explain the discrepancies between studies. More comments in the Editorial.

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