Geraldine Pedraza Urueña

Hormonal regulation in women plays a fundamental role not only in reproductive physiology, but also in metabolic and cardiovascular homeostasis throughout life. Recent scientific evidence demonstrates that endocrine transitions and hormonal disorders influence endothelial function, lipid metabolism, insulin sensitivity, inflammatory pathways, adipose tissue distribution, and long-term cardiovascular risk. This review aimed to analyze the systemic effects of female hormonal regulation beyond reproduction, emphasizing its relationship with metabolic and cardiovascular health through an interdisciplinary perspective integrating gynecology, endocrinology, cardiology, and public health. A narrative and integrative literature review methodology was employed using peer-reviewed scientific publications indexed in internationally recognized databases, including PubMed, Scopus, ScienceDirect, and Google Scholar. Contemporary evidence related to menopause, polycystic ovary syndrome, hypertensive disorders of pregnancy, hormonal therapies, endothelial dysfunction, insulin resistance, and cardiometabolic disease was analyzed and synthesized. The reviewed evidence demonstrated that menopause is strongly associated with endothelial dysfunction, visceral adiposity, dyslipidemia, insulin resistance, and increased cardiovascular risk. Polycystic ovary syndrome was identified as a multisystemic endocrine-metabolic disorder closely linked to obesity, chronic inflammation, hyperandrogenism, and future risk of type 2 diabetes mellitus. Additionally, pregnancy-related hypertensive disorders such as preeclampsia and gestational hypertension were associated with elevated long-term risk of chronic hypertension, ischemic heart disease, and cerebrovascular disease. Hormonal therapies and contraceptive methods demonstrated both beneficial vascular effects and potential thrombotic risks depending on patient characteristics and individualized cardiovascular profiles.

Cardiometabolic diseases currently represent one of the leading causes of morbidity and mortality worldwide. The growing coexistence of obesity, insulin resistance, type 2 diabetes mellitus, hypertension, dyslipidemia, chronic kidney disease, and cardiovascular disease has contributed to the development of the cardiometabolic continuum concept, which describes the progressive interaction between metabolic and cardiovascular dysfunction. The objective of this review was to analyze the current scientific evidence regarding the integration of cardiovascular and endocrine risk factors within contemporary clinical practice, emphasizing pathophysiological mechanisms, epidemiological impact, preventive strategies, and therapeutic approaches associated with cardiometabolic disease. A narrative and analytical literature review was conducted using scientific databases including PubMed, Scopus, ScienceDirect, and major international medical journals. Priority was given to clinical guidelines, randomized clinical trials, systematic reviews, and epidemiological studies published in recent years. The analysis focused on the relationship between obesity, inflammation, endothelial dysfunction, insulin resistance, atherosclerosis, cardiovascular disease, and chronic kidney disease, with particular attention to Latin American populations from Mexico, Colombia, and Ecuador. The reviewed evidence demonstrated that cardiometabolic diseases evolve through interconnected inflammatory, metabolic, vascular, and renal mechanisms rather than isolated pathological processes. Obesity and insulin resistance were identified as major contributors to systemic inflammation, endothelial injury, oxidative stress, and accelerated cardiovascular deterioration. Major clinical trials evaluating sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists showed significant reductions in cardiovascular events, heart failure hospitalization, renal disease progression, and cardiometabolic complications.