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Sex Hormones

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Diagnosis and Treatment of Pulmonary Hypertension

Abstract

Males and females are biologically distinct, and certain pathological conditions affect both sexes differently. Obvious sex difference exists in pulmonary arterial hypertension (PAH). The major sex difference is female sex hormones, especially estrogens, and therefore, the roles of estrogens have been intensively studied in PAH. The incidence of PAH in females is higher than in males, suggesting a female-specific risk factor. However, a general notion that estrogens are cardiovascular protective, and their protective effects demonstrated in animal models, resulted in the emerging concept of “estrogen paradox” in PAH. Later, it was found that female PAH patients live longer, suggesting the survival benefit of estrogens. Questions that need to be answered are (1) Why is PAH more prevalent in females despite the protective effects of estrogens? and (2) Why do female PAH patients show better survival despite the higher incidence of the syndrome? Even with the rigorous research efforts to answer these paradoxical questions, the field has not come to a consensus. This chapter summarizes the current leading theories for the estrogen paradox in PAH.

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Acknowledgment

We thank Dr. Ivan F. McMurtry for the critical reading and suggestions for this chapter.

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Authors and Affiliations

  1. Department of Pharmacology, College of Medicine, University of South Alabama, Mobile, AL, 36688, USA

    Kaori Oshima & Masahiko Oka

  2. Center for Lung Biology, College of Medicine, University of South Alabama, Mobile, AL, 36688, USA

    Kaori Oshima & Masahiko Oka

  3. Department of Internal Medicine, College of Medicine, University of South Alabama, Mobile, AL, 36688, USA

    Masahiko Oka

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  1. Kaori Oshima
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Correspondence to Masahiko Oka .

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  1. Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan

    Yoshihiro Fukumoto

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Oshima, K., Oka, M. (2017). Sex Hormones. In: Fukumoto, Y. (eds) Diagnosis and Treatment of Pulmonary Hypertension. Springer, Singapore. https://doi.org/10.1007/978-981-287-840-3_4

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  • DOI: https://doi.org/10.1007/978-981-287-840-3_4

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  • Publisher Name: Springer, Singapore

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  • Online ISBN: 978-981-287-840-3

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