Table 1.

Take-home messages.

Endothelial dysfunction. Is caused by increased ROS produced by xanthine-oxidase activity or is dependent on the direct action of sex hormones on the receptors exhibited by endothelial cells.

Estrogen promotes the release of NO and on the other hand, prevents the production of oxygen free radicals and the chronic inflammatory state deriving from the metabolism of the uric acid.

Estrogens play a major role in regulating serum levels of uric acid, resulting in less accumulation in the walls of blood vessels and therefore limiting endothelial damage compared to men.

In men, androgen stimulation plays a protective role in the cardiovascular system with both a direct and secondary action on the vascular endothelium by converting to estrogen.

Menopause and andropause increase uric acid levels and endothelial damage, but the association of this phenomenon with cardiovascular mortality remains unclear.