Endothelial dysfunction in post- menopausal women

Menopause is accompanied by the onset of endothelial dysfunction, and this is considered to be a major mechanism of cardiovascular events. The changing hormonologic environment seems to be the key mechanism leading to endothelial dysfunction in menopause. Epidemiological studies showed a higher incidence of cardiovascular events in age-matched postmenopausal women compared with premenopausal women. The therapeutic approach to postmenopausal women includes lifestyle modifications as well as pharmacological interventions primarily targeting hypertension and insulin resistance or metabolic syndrome. Angiotensin-coverting enzyme inhibitors (ACEi), angiotensin II receptor blockers and statins have been proven effective in improving endothelial function in this group of patients. To time, estrogen therapy seems to exert some beneficial action towards the restoration of vascular homeostasis when administered early after menopause. However, it is still premature to state which is the most efficient therapeutic strategy targeting vascular endothelium in postmenopausal women.