The incidence and severity of atherosclerosis in estrogen treated males, and in females with a hypoestrogenic or a hyperestrogenic state. Circulation 9: 533

Autopsy records of estrogen-treated men, castrated women, and women with breast carcinoma were analyzed with reference to the degree of atherosclerotic disease. Findings were then compared with those in similar groups of men and women whose estrogen supply was considered normal. Re-sults obtained suggest: (1) that the male treated with estrogen has less atherosclerosis than the normal male; (2) that the oophorectomized female has an incidence of severe atherosclerosis ap-proaching that of the male; and (3) that the hyperestrogenic female with breast carcinoma has less atherosclerosis than the normal female. THE REMARKABLE sex difference in the incidence of atherosclerosis4 ' 12, 17 suggests that estrogenic hormones may exert an inhibitory effect on the pathogenesis of this disease. In order to explore this pos-sibility, clinical and autopsy statistics were compiled in groups of patients who demon-strated deviations from their normal estrogen supply. Hyperestrogenism in males was studied in patients with carcinoma of the prostate who were treated with estrogens. Hyperestrogenism in females was considered to be present in women with carcinoma of the breast.10 ' 23 The hypoestrogenic state was studied in a group of surgically castrated females. The incidence and severity of atherosclerosis in these patients were then compared with that in similar groups who were apparently normal with reference to their estrogen supply. MATERIALS AND METHODS Autopsy protocols and clinical histories of 153 patients with carcinoma of the prostate were ex-amined. Of these patients 53 were given estrogen therapy for three months or more, 100 received estrogen for less than three months or no hormon