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Int. J. Mol. Sci. 2016, 17(5), 760; doi:10.3390/ijms17050760

Heart Disease in Women: Unappreciated Challenges, GPER as a New Target

Discipline of Medicine, Memorial University of Newfoundland, St. John’s, NL A1B 3V6, Canada
Academic Editor: Anastasia Susie Mihailidou
Received: 22 March 2016 / Revised: 9 May 2016 / Accepted: 11 May 2016 / Published: 18 May 2016
(This article belongs to the Special Issue Molecular Research on Hypertension)
View Full-Text   |   Download PDF [197 KB, uploaded 18 May 2016]

Abstract

Heart disease in women remains underappreciated, underdiagnosed and undertreated. Further, although we are starting to understand some of the social and behavioral determinants for this, the biological basis for the increased rate of rise in atherosclerosis risk in women after menopause remains very poorly understand. In this review we will outline the scope of the clinical issues related to heart disease in women, the emerging findings regarding the biological basis underlying the increased prevalence of atherosclerotic risk factors in postmenopausal women (vs. men) and the role of the G protein-coupled estrogen receptor (GPER) and its genetic regulation as a determinant of these sex-specific risks. GPER is a recently appreciated GPCR that mediates the rapid effects of estrogen and aldosterone. Recent studies have identified that GPER activation regulates both blood pressure. We have shown that regulation of GPER function via expression of a hypofunctional GPER genetic variant is an important determinant of blood pressure and risk of hypertension in women. Further, our most recent studies have identified that GPER activation is an important regulator of low density lipoprotein (LDL) receptor metabolism and that expression of the hypofunctional GPER genetic variant is an important contributor to the development of hypercholesterolemia in women. GPER appears to be an important determinant of the two major risk factors for coronary artery disease-blood pressure and LDL cholesterol. Further, the importance of this mechanism appears to be greater in women. Thus, the appreciation of the role of GPER function as a determinant of the progression of atherosclerotic disease may be important both in our understanding of cardiometabolic function but also in opening the way to greater appreciation of the sex-specific regulation of atherosclerotic risk factors. View Full-Text
Keywords: estrogen; aldosterone; G protein-coupled estrogen receptor (GPER); hypertension; dyslipidemia; atherosclerosis estrogen; aldosterone; G protein-coupled estrogen receptor (GPER); hypertension; dyslipidemia; atherosclerosis
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Feldman, R.D. Heart Disease in Women: Unappreciated Challenges, GPER as a New Target. Int. J. Mol. Sci. 2016, 17, 760.

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