Endothelial aging and gender

The endothelium plays a pivotal role in maintaining vascular homeostasis, mainly by the production of the relaxing factor nitric oxide, which protects the vessel wall from the development of atherosclerosis.Aging is a powerful cardiovascular risk factor, associated with endothelial dysfunction both in normotensive subjects and in hypertensive patients. Premenopausal normotensive women are protected against the deleterious effect of aging on endothelial function, and age-related impairment of endothelial function is attenuated in premenopausal hypertensive women. This protective effect on endothelium seems to be mediated by endogenous estrogen, which preserves nitric oxide availability by activating the l-arginine-NO pathway in normotensive women and by inhibiting reactive oxygen species generation.Whether endogenous androgen may modulate endothelial function and the mechanisms involved are still unsolved issues, since data concerning the effect of testosterone on endothelium are scanty and contradictory.