Sex differences in vascular endothelial function and health in humans: impacts of exercise

Abstract

New Findings r What is the topic of this review?This brief review discusses potential sex differences in arterial function across the age span, with special emphasis on the effects of oestrogen and testosterone on the vascular endothelium. r What advances does it highlight?We discuss the relationship between the impacts of sex hormones on arterial function and health in the context of epidemiological evidence pertaining to the menopause and ageing. Studies performed in humans are emphasized, alongside insights from animal studies. Findings suggest that the combination of exercise and hormone administration should be potentially synergistic or additive in humans.This brief review presents historical evidence for the purported impacts of male and female sex hormones on the vasculature in humans, including effects on macro-and microvascular function and health. Impacts of ageing on hormonal changes and arterial function are considered in the context of the menopause. Physiological data are presented alongside clinical outcomes from large trials, in an attempt to rationalize disparate findings along the bench-to-bedside continuum. Finally, the theoretical likelihood that exercise and hormone treatment may induce synergistic and/or additive vascular adaptations is developed in the context of recent laboratory studies that have compared male and female responses to training. Differences between men and women in terms of the impact of age and cardiorespiratory fitness on endothelial function are addressed. Ultimately, this review highlights the paucity of high-quality and compelling evidence regarding the fundamental impact, in humans, of sex differences on arterial function and the moderating impacts of exercise on arterial function, adaptation and health at different ages in either sex.

Effects of Exercise on Vascular Function, Structure, and Health in Humans

“…This proposal requires further investigation and the situation may be different in healthy subjects and those with elevated sympathetic drive a priori (Roveda et al 2003;Carter and Ray 2015). It is also now clear that important differences in autonomic function may result from differences in receptor density and function that exist between men and women of different ages (Green et al 2015;Joyner et al 2015).…”

Evidence for Shear Stress–Mediated Dilation of the Internal Carotid Artery in Humans

“…To control for the effect of changes in circulating hormones on vascular function, all women were assessed within the first 7 days of the follicular phase of the menstrual cycle. 20 The study was approved by the University of Western Australia's Human Research Ethics Committee and conformed to the standards outlined in the Declaration of Helsinki. Participants were informed of all experimental procedures and any potential associated risks.…”

Shiftwork and decline in endothelial function among police officers

“…Although it is not completely clear why this same association was not observed among the female officers, there are a few possible reasons. Estrogen levels have been shown to be directly associated with better endothelial function [Teede ; Green et al, ]. One study showed that FMD declined in men at an earlier age than in women and that menopause was correlated with a steep FMD decline [Celermajer et al, ].…”

“…Fewer women in this cohort work on the night shift compared with men. Also, levels of male and female sex hormones may impact the vasculature [Green et al, ]. Therefore, a secondary objective was to determine if gender significantly modified the relationship between shiftwork and change in endothelial function.…”