Estrogen Receptor Signaling and Cardiovascular Function

Over the last decades, our understanding about the role of estrogens has increased dramatically. Estrogens impact several tissues, organs, and systems well beyond fertility. In particular, estrogens impact the cardiovascular system and are responsible for the well-accepted protective role against vascular dysfunction and cardiovascular dysfunction in females relative to males. Conversely, lack of estrogens results in increased incidence of atherosclerosis and CVD which result in worse outcomes in postmenopausal women compared to men. However, estrogen replacement therapy in this scenario not only fails to restore protection against CVD, but can worsen its clinical manifestation, an unexpected observation that has prompted further research and investigation about the mechanisms of estrogen action in the vasculature. In this chapter, we try to uncover the complex mechanisms underlying the actions of estrogens in the vasculature as well as in the cardiovascular system that explain the role of estrogens in cardiovascular disease.