Data from the Framingham Heart Study suggest that women may be more sensitive to the deleterious cardiovascular remodeling effects of aldosterone. Previous studies from our laboratory have shown that chronic treatment with spironolactone, a mineralocorticoid receptor (MR) antagonist, decreases ischemic cerebral infarct size and prevents remodeling of the middle cerebral artery (MCA) in male spontaneously hypertensive stroke-prone rats (SHRSP). Therefore, we hypothesized that MR antagonism would reduce ischemic infarct size and prevent MCA remodeling in female SHRSP. Six-week-old female SHRSP were treated for 6 wk with spironolactone (25 or 50 mg.kg(-1).day(-1)) or eplerenone (100 mg.kg(-1).day(-1)) and compared with untreated controls. At 12 wk, cerebral ischemia was induced for 18 h using the intraluminal suture occlusion technique, or the MCA was isolated for analysis of passive structure using a pressurized arteriograph. MR antagonism had no effect on infarct size or passive MCA structure in female SHRSP. To study the potential effects of estrogen, the above experiments were repeated in bilaterally ovariectomized (OVX) female SHRSP treated with spironolactone (25 mg.kg(-1).day(-1)). Infarct size and vessel structure in OVX SHRSP were not different from control SHRSP. Spironolactone had no effect on infarct size in OVX SHRSP. However, MCA lumen and outer diameters were increased in spironolactone-treated OVX SHRSP, suggesting an effect of estrogen. Cerebral artery MR expression, assessed by Western blotting, was increased in female, compared with male, SHRSP. These studies highlight an apparent sexual dimorphism of MR expression and activity in the cerebral vasculature from hypertensive rats.

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Purpose: Wearable cardioverter defibrillators (WCDs) provide lifesaving defibrillation and are equipped with accelerometers, capable of providing information on patient wear time and physical activity (PA). The purpose of this study was to report on patient PA while wearing a WCD. Methods: This study derived data from the WCD vendor in patients prescribed WCD post–myocardial infarction (MI) with left ventricular ejection fraction ≤35% in 2016. Using the device accelerometer, the relationship between wear time and PA was examined in a sample of consistent wearers of the WCD. Demographic variables, including sex and age, were examined for impact on wear time and PA. Changes in PA over time were also examined. Results: A total of 1952 patients (71% male) with a median age of 63 yr were included. Descriptive analyses indicated that overall median wear time was 23.8 hr/d; PA was 5568 steps/d. Significant differences in PA over time were identified, with median steps increasing by 67% from the first week of wear to the last week of wear. Patient age and wear time significantly predicted PA; patient age also significantly predicted patient wear time. There were significant differences in median hours of wear time, as well as median steps, based on sex. Conclusions: PA in adults early after hospital discharge is modest and improves over the course of the 90-d WCD prescription in regular wearers. Improved health status may account for this change. The WCD accelerometer may have value in future clinical care and research by providing a window into daily patient PA levels via remote monitoring.