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- Title
Glucocorticoids and Cardiovascular Disease.
- Authors
Brian R Walker
- Abstract
Chronic excessive activation of glucocorticoid receptors induces obesity, insulin resistance, glucose intolerance, dyslipidaemia and hypertension. Subtle abnormalities of the hypothalamic–pituitary–adrenal axis and/or of tissue sensitivity to glucocorticoids are also associated with these cardiovascular risk factors in patients with the metabolic syndrome. Furthermore, glucocorticoids have direct effects on the heart and blood vessels, mediated by both glucocorticoid and mineralocorticoid receptors and modified by local metabolism of glucocorticoids by the 11{szligbeta}-hydroxysteroid dehydrogenase enzymes. These effects influence vascular function, atherogenesis and vascular remodelling following intra-vascular injury or ischaemia. This article reviews the systemic and cardiovascular effects of glucocorticoids, and the evidence that glucocorticoids not only promote the incidence and progression of atherogenesis but also modify the recovery from occlusive vascular events and intravascular injury. The conclusion is that manipulation of glucocorticoid action within metabolic and cardiovascular tissues may provide novel therapeutic avenues to combat cardiovascular disease.
- Subjects
GLUCOCORTICOID receptors; CARDIOVASCULAR diseases; METABOLIC syndrome; DISEASE risk factors
- Publication
European Journal of Endocrinology, 2007, Vol 157, Issue 5, p545
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-07-0455