When Gonads Talk to the Heart

Cardiovascular risk is significantly lower in normally cycling women compared with men. This difference is abolished after menopause, suggesting a link with sex steroid hormones. Early studies on cardiac endocrine function disclosed higher natriuretic peptide concentrations in women than in men, suggesting the hypothesis that female sex steroid hormones could directly stimulate cardiomyocyte hormone production and secretion (1). Kuroski de Bold (2) hypothesized that an improved cardiovascular risk profile in cycling women could be associated with some estrogen stimulatory effect on cardiac endocrine function. Indeed, cardiac natriuretic peptides exert several protective actions on the heart and vessels, including: 1) vasodilatation; 2) promotion of diuresis/natriuresis; and 3) inhibition of hypertrophy, fibrosis, and apoptosis either directly or via inhibition of the sympathetic and renin-angiotensin-aldosterone systems, as well as the release or action of endothelin and vasopressin (1).