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February 26, 2003
Low Estrogen Increases Heart Risk in Young Women

Coronary artery disease (CAD) is the leading killer of premenopausal
women, even ahead of breast cancer. Little is known regarding relatively
young, premenopausal women and CAD pathophysiology and management, as
previous studies have focused on heart disease and hormone replacement
therapy in older women. The following study is the first to show that
premenopausal women with low estrogen levels have a significantly
greater prevalence of coronary artery disease.

Recently, researchers in the Women's Ischemia Syndrome Evaluation (WISE)
study at Cedars-Sinai Medical Center, Los Angeles, found that premenopausal women with CAD visible on angiography had significantly lower estradiol, bioavailable estradiol, estrone, and follicle-stimulating hormone (FSH) than women without CAD, even after controlling for age. Theseresults support the concept that female protection is lost when ovarian function is disrupted and are consistent with previous work showing that elevated CAD risk is associated with
premature menopause. Premenopausal atherosclerosis may be related to
stress-induced disruption of the menstrual cycle which results in low
estrogen levels. Women who use anxiolytic/sedative/hypnotic medications
are more likely to be hypoestrogenemic. This study also showed a strong
association between diabetes and low estrogen levels.

Journal of the American College of Cardiology 2003;41:413-419

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