International Society of Hypertension

New Investigators Network

What's On My Desk


Anastasia Mihailidou, Sydney, Australia

Posted on 16/10/2018

We are delighted to receive this week's What's On My Desk contribution from Anastasia Mihailidou, ISH Mentorship Committee Member from the Cardiology Department & Kolling Institute, Northern Sydney Local Health District & Macquarie University, Sydney, Australia.

Anastasia MihailidouAnastasia Mihailidou, ISH Mentorship Committee Member from Cardiology Department & Kolling Institute, Northern Sydney Local Health District & Macquarie University, Sydney, Australia



Endogenous Sex Hormones & Incident Cardiovascular Disease in Post-Menopausal Women

Di Zhao, Eliseo Guallar, Pamela Ouyang, Vinita Subramanya, Dhananjay Vaidya, Chiadi E. Ndumele, Joao A. Lima, Matthew A. Allison, Sanjiv J. Shah, Alain G. Bertoni, Matthew J. Budoff, MD, Wendy S. Post, Erin D. Michos

J Am Coll Cardiol 2018;71:2555–66


 Why I selected this manuscript?

This drew my attention since it is very close to my research interest and contributes towards improving our understanding of the increased risk of heart disease for women. The aim of the study was to determine whether there is an association between sex hormone levels and incident cardiovascular disease (CVD), coronary heart disease (CHD) and heart failure (HF) events, since previous studies have provided conflicting results. The strengths of this study are that these post-menopausal women (mean age 64.9 ± 8.9 years) were from the well characterised community-based MESA (Multi-Ethnic Study of Atherosclerosis) Study, were followed for 12 years and importantly had no CVD at baseline. The findings were interesting, post-menopausal women with higher testosterone/estradiol ratio had elevated risk for incident CVD, CHD, and HF events, while higher levels of testosterone were associated with increased CVD and CHD. The potential mechanisms for this increased CVD risk could not be defined but may be extrapolated from previous preclinical studies from my laboratory (Le et al. 2014). We found that expression of the multiligand receptor for advanced glycation end products (RAGE) is dependent on circulating testosterone rather than estrogen levels in both male and female rats. RAGE stimulation activates proapoptotic caspase cascade, resulting in cardiomyocyte apoptosis leading to cardiac damage.

Le TYL, Ashton AW, Mardini M, Stanton PS, Funder JW, Handelsman DJ, Mihailidou AS. (2014). Role of Androgens in Sex Differences in Cardiac Damage During Myocardial Infarction. Endocrinology 155: 568–575.

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