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(Circulation. 1995;91:2694-2698.)
© 1995 American Heart Association, Inc.

Articles

Testosterone and Thromboxane

Of Muscles, Mice, and Men

Domenico Pratico, MD; Garret A. FitzGerald, MD

From the Center for Experimental Therapeutics, University of Pennsylvania (Philadelphia).

Correspondence to Dr G.A. FitzGerald, Center for Experimental Therapeutics, 909 Biomedical Research Building-1, University of Pennsylvania, 422 Curie Blvd, Philadelphia, PA 19104.

Key Words: genes • editorials • steroids • testosterone • thromboxane

	Introduction

 
The age-dependent increase in death from cardiovascular disease is less pronounced in premenopausal women than in men, but this divergence of risk narrows after middle age.¹ This results from a relative increase in the death rate in women after the menopause.² It has been suggested that the immediate postmyocardial infarction death rate is higher in postmenopausal women than in men.^{3 4 5 6} However, standardization of the data for age and major risk factors, such as hypertension, diabetes, and hypercholesterolemia, accounts for most, but not all, of this difference. Such multivariate adjustment also suggests that mortality at 3 years among hospital survivors of an infarction actually is lower in women than in men.^{7 8} The reasons why in-hospital mortality may still be slightly higher in women than men remain open to question and have recently been reviewed.⁸ Reasons include the delay in seeking medical care for women with coronary symptoms,^{9 10 11 12} a higher prevalence of silent or unrecognized infarctions in women than in men,¹³ psychosocial disparities,^{14 15} and the tendency of women to experience more complications after a myocardial infarction than do men. Complications include cardiogenic shock,^{16 17 18 19} congestive heart failure,^{20 21} and cardiac rupture.²² Although it is tempting to attribute the changing incidence of cardiovascular events in women to alterations in sex steroid production at the time of the menopause, it remains to be established that such a causal link exists. If it does, the mechanism is obscure. Complex alterations in both male and female sex hormones occur in women at the time of the menopause. Serum . . . [Full Text of this Article]

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