The endothelium in health and in cardiovascular disease

Significant new findings in the last decade have demonstrated that the vascular endothelium is an important regulatory organ in maintaining cardiovascular homeostasis and that endothelial dysfunction is present in several cardiovascular diseases. With the production of multiple vasoactive substances the normal endothelium modulates the tone of the underlying vascular smooth muscle. These include endothelium-derived relaxing factors such as prostacyclin (PG1(2)), nitric oxide (NO) and endothelium-derived hyperpolarizing factor (EDHF) and vasoconstrictors such as endothelin-1 and angiotensin II. The antiplatelet, antithrombotic and antifibrinolytic properties of the normal endothelium contribute to the maintenance of the fluidity of the blood. Activation or injury to the endothelial cells disrupts the function of the endothelial cells leading to the development of endothelial dysfunction. Endothelial dysfunction is accompanied by vasospasm, thrombosis, and atherosclerosis. It is present in cardiovascular diseases such as hypertension, atherosclerotic heart diseases, congestive heart failure and many others. It has been shown that some therapeutic effects of drugs such as angiotensin-enzyme inhibitors is in part due to the overcoming of endothelial dysfunction

Enfermedad coronaria en la mujer / Coronary disease in woman

Coronary heart disease is the leading cause of death among women, with a high prevalence in the older women. Women have a less favorable outcome after myocardial infarction and after myocardial revascularization procedures. We have revised the most up to date published information about risk factors for coronary heart disease in women. The most salient features concerning lipids, hypertension, diabetes, cigarette smoking, physical activity and obesity are summarized. The differences on clinical manifestations of coronary heart disease among men and women are also presented. The salient data about estrogen replacement therapy effect on coronary heart disease on postmenopausal women is also summarized.