Amparo Villablanca

Carole L. Banka

CN Bairey Merz

J Hsia

KK Schnoes

English

PubMed

Banka, Carole L.

Villablanca, Amparo

eScholarship - University of California

Letter from the Guest Editors

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Letter from the Guest Editors
Carole L. Banka & Amparo Villablanca
Received: 18 May 2009 /Accepted: 22 May 2009 /Published online: 1 July 2009
# The Author(s) 2009. This article is published with open access at Springerlink.com
The simple fact that this special issue is being published
suggests that “we've come a long way, baby.” From obesity,
vitamin D, and dietary intervention to interventional
cardiology and maternal effects on cardiovascular risk in
offspring, this issue includes more than a conventional
discussion of heart disease in women and differentiates the
dogma from the data. Of course, much remains to be
explored.
Much of the sexual bias in risk, symptom presentation,
and treatment outcome is likely due to pleiotropic effects of
the sex steroids (estrogens, androgens, and progestins) on
cells and tissues involved in the constellation of cardiovas-
cular diseases. From a basic science standpoint, animal
models have taught us much about sex differences in cell
and tissue characteristics, particularly as they contribute to
atherogenic mechanisms. Going forward, in vitro and in
vivo models will be crucial to unraveling the genetics
associated with sex differences. Whereas studies of single
genes can be fruitful, more sophisticated approaches using
microarrays and gene expression profiling such as the
recent study by Mendelsohn and his colleagues [1] have
greater potential for illuminating sex differences in vascular
gene activation and are likely to have significant transla-
tional impact.
From a clinical perspective, the controversy surround-
ing postmenopausal hormone treatment continues as
discussed in the editorials by Barrett-Connor and
Wenger. The suggestion from the Women's Health
Initiative that estrogen intervention at or shortly after the
menopause may be protective [2], now known as the
“critical timing” hypothesis, warrants further investiga-
tion. The Kronos Early Estrogen Prevention Study is
designed to address this very question (see Miller et al. in
this issue). Furthermore, the Women's Ischemia Syndrome
Evaluation Study has shed significant light on the vascular
characteristics underlying the fact that women's symptoms
differ markedly from those of men, a critically important
area of research [3]. In addition, there is much to be done
to improve the pharmacologic treatment of women as
reviewed by Oertelt-Prigone and Regitz-Zagrosek in this
issue. Going forward, we anticipate that the data, the
provocative questions, and the potential for future exper-
imentation presented in this issue will translate into
increased awareness and critical improvements in the
prevention, diagnosis, and treatment of cardiovascular
disease in women.
Open Access This article is distributed under the terms of the
Creative Commons Attribution Noncommercial License which per-
mits any noncommercial use, distribution, and reproduction in any
medium, provided the original author(s) and source are credited.
References
1. Schnoes, K. K., Jaffe, I. Z., Iyer, L., Dabreo, A., Aronovitz, M.,
Newfell, B., et al. (2008). Rapid recruitment of temporally distinct
vascular gene sets by estrogen. Molecular Endocrinology, 22(11),
2544–2556.
2. Hsia, J., Langer, R. D., Manson, J. E., Kuller, L., Johnson, K. C.,
Hendrix, S. L., et al. (2006). Conjugated equine estrogens and
coronary heart disease: The Women's Health Initiative. Archives of
Internal Medicine, 166(3), 357–365.
3. Bairey Merz, C. N., Shaw, L. J., Reis, S. E., Bittner, V., Kelsey,
S. F., Olson, M., et al. (2006). Insights from the NHLBI-
Sponsored Women's Ischemia Syndrome Evaluation (WISE)
Study: Part II: Gender differences in presentation, diagnosis,
and outcome with regard to gender-based pathophysiology of
atherosclerosis and macrovascular and microvascular coronary
disease. Journal of the American College of Cardiology, 47(3
Suppl), S21–S29.
J. of Cardiovasc. Trans. Res. (2009) 2:227
DOI 10.1007/s12265-009-9115-8
C. L. Banka (*) :A. Villablanca
University of California San Diego,
San Diego, CA, USA
e-mail: cbanka@ucsd.edu
A. Villablanca
University of California Davis,
Davis, CA, USA
e-mail: avillablanca@ucdavis.edu


Crossref

Conjugated equine estrogens and coronary heart disease: The Women's Health Initiative.

Rapid recruitment of temporally distinct vascular gene sets by estrogen.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2719732

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