Estrogen levels and the risk of cardiovascular events in older women

BACKGROUND: Estrogens play a crucial role in the functioning of the reproductive, cardiovascular, skeletal, and central nervous systems. However, existing literature on the correlation between estrogen levels and the risk of cardiovascular events in elderly populations is limited and contradictory. AIM: To assess the effect of estrogen levels on the incidence of myocardial infarction and stroke in older women. MATERIALS AND METHODS: The Crystal study was a population-based cross-sectional cohort study which included community-dwelling individuals aged 65 and older (n = 280). Key study parameters included survey responses and medical record analysis for non-communicable chronic diseases, alongside laboratory assessments for estradiol, thyroid-stimulating hormone, glycated hemoglobin, total protein, albumin, lipid panel, C-reactive protein, complete blood count, and creatinine levels. RESULTS: A history of stroke was recorded in 18.9% (n = 54) of participants, while myocardial infarction was reported in 11.9% (n = 34). In participants with estradiol levels in the 4th quintile (55 pmol/l), stroke incidence was 2.5 times higher (odds ratio 2.480; 95% confidence interval 1.180–5.211) and myocardial infarction incidence was 2 times higher (odds ratio 2.003; 95% confidence interval 1.088–3.687) after adjustments for age and high-density lipoprotein levels. CONCLUSIONS: An estradiol level greater than 55 pmol/l is an independent risk factor for the development of stroke and myocardial infarction in women aged 65 years and older.