Impact of age and sex on neural cardiovascular responsiveness to cold pressor test in humans

Keller‐Ross, Manda L.; Cunningham, Hannah A; Carter, Jason R.

doi:10.1152/ajpregu.00045.2020

Cited by 22 publications

(23 citation statements)

References 55 publications

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“…We now extend these findings and demonstrate attenuated sympathetically mediated vasoconstriction in women during systemic hypoxia. The rise in plasma adrenaline, noradrenaline and muscle sympathetic nerve activity in response to systemic hypoxia (Casey et al, 2014;Jones et al, 1999) and the CPT (Hogarth et al, 2007;Jarvis et al, 2011;Jones et al, 1996;Keller-Ross et al, 2020;Miller et al, 2019) are not different between men and women. For these reasons, we speculate sex differences in the vasoconstrictor response to sympathetic activation during systemic hypoxaemia are due to downstream vascular responses to sympathetic stimulation.…”

Section: Discussionmentioning

confidence: 87%

“…CPT is a well-established sympathoexcitatory stimulus used to assess α-adrenergic receptor-mediated vasoconstriction (Dinenno et al, 2001;Frank & Raja, 1994;Kooijman et al, 2009). Notably, the level of sympathetic nervous system activation in response to the CPT is reliably repeatable within study visits (Dillon et al, 2020) and the sympathetic response to CPT does not differ between men and women (Hogarth et al, 2007;Jarvis et al, 2011;Jones et al, 1996;Keller-Ross et al, 2020;Miller et al, 2019).…”

Section: Protocolmentioning

confidence: 99%

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Sex differences in the vascular response to sympathetic activation during acute hypoxaemia

Jacob

Harper

Ivie

et al. 2021

Experimental Physiology

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Activation of the sympathetic nervous system causes vasoconstriction and a reduction in peripheral blood flow. Sympathetically mediated vasoconstriction may be attenuated during systemic hypoxia to maintain oxygen delivery; however, in predominantly male participants sympathetically mediated vasoconstriction is preserved or even enhanced during hypoxaemia. Given the potential for sex-specific differences in hypoxic vascular control, prior results are limited in application. We tested the hypothesis that young women attenuate sympathetically mediated vasoconstriction during steady-state hypoxaemia, whereas men do not. Healthy young men (n = 13, 25 ± 4 years) and women (n = 11, 24 ± 4 years) completed two trials consisting of a 2-min cold pressor test (CPT, a well-established sympathoexcitatory stimulus) during baseline normoxia and steady-state hypoxaemia. Beat-to-beat blood pressure (finger photoplethysmography) and forearm blood flow (venous occlusion plethysmography) were measured continuously. Total and forearm vascular conductance (TVC and FVC, respectfully) were calculated. A change (Δ) in TVC and FVC from steady-state during the last 1 min of CPT was calculated and differences between normoxia and systemic hypoxia were assessed. In men, the reduction in TVC during CPT was greater during hypoxia compared to normoxia (ΔTVC, P = 0.02), whereas ΔTVC did not differ between conditions in women (P = 0.49). In men, ΔFVC did not differ between normoxia and hypoxia (P = 0.92). In women, the reduction in FVC during CPT was attenuated during hypoxia (ΔFVC, P < 0.01). We confirm sympathetically mediated vasoconstriction is preserved or enhanced during hypoxaemia in young men, whereas peripheral vascular responsiveness to sympathetic activation during hypoxaemia is attenuated in young women. The results advance our understanding of sex-related differences in hypoxic vascular control.

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Section: Discussionmentioning

confidence: 87%

Section: Protocolmentioning

confidence: 99%

Sex differences in the vascular response to sympathetic activation during acute hypoxaemia

Jacob

Harper

Ivie

et al. 2021

Experimental Physiology

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“… 4 , 23 , 24 , 25 Besides, greater SNS responsiveness to the cold pressor test measured as increased MSNA has been reported in 60‐year‐old women compared to men of similar age. 26 Although insulin increases MSNA, 27 , 28 basal insulin concentrations were similar in men and women, regardless of ACEI/ARB treatment (Table 3 ).…”

Section: Discussionmentioning

confidence: 92%

Treatment of hypertension with angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers and resting metabolic rate: A cross‐sectional study

Pedrianes-Martin

Martin‐Rincon

Morales-Álamo

et al. 2021

J of Clinical Hypertension

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Hypertension in obese and overweight patients is associated with an elevated resting metabolic rate (RMR). The aim of this study was to determine whether RMR is reduced in hypertensive patients treated with angiotensin‐converting enzyme inhibitors (ACEI) and blockers (ARB). The RMR was determined by indirect calorimetry in 174 volunteers; 93 (46.5 %) were hypertensive, of which 16 men and 13 women were treated with ACEI/ARB, while 30 men and 19 women with untreated hypertension served as a control group. Treated and untreated hypertensives had similar age, BMI, physical activity, and cardiorespiratory fitness. The RMR normalized to the lean body mass (LBM) was 15% higher in the untreated than ACEI/ARB‐treated hypertensive women ( p = .003). After accounting for LBM, whole‐body fat mass, age, the double product (heart rate x systolic blood pressure), and the distance walked per day, the RMR was 2.9% lower in the patients taking ACEI/ARB ( p = .26, treatment x sex interaction p = .005). LBM, age, and the double product explained 78% of the variability in RMR ( R 2 = 0.78, p < .001). In contrast, fat mass, the distance walked per day, and total T4 or TSH did not add predictive power to the model. Compared to men, a greater RMR per kg of LBM was observed in untreated hypertensive overweight and obese women, while this sex difference was not observed in patients treated with ACEI or ARBs. In conclusion, our results indicate that elevated RMR per kg of LBM may be normalized by antagonizing the renin‐angiotensin system.

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“…We focused on autonomic responses and sex differences in cardiovascular responses elicited by the cold pressor, as demonstrated in earlier studies. For example, older women with elevated blood pressure showed higher blood pressure increases in response to the cold pressor compared to younger women and men, while postmenopausal women showed stronger sympathetic responses to the cold pressor compared to age-matched men [47, 48]. In another study, compared to men, women show higher heart rate, lower systolic and diastolic blood pressure, and reduced autonomic responses (parasympathetic nervous system indicator defined as heart rate variability high frequency/total power) in response to the cold pressor [31].…”

Section: Discussionmentioning

confidence: 99%

“…A challenge that involves both temperature and pain regulation in addition to raising blood pressure is the cold pressor, which involves immersion of an extremity in near-freezing cold water [26][27][28][29][30][31]. Autonomic responses to the cold pressor challenge are reproducible, and show variations associated with coronary risk, and whether a person will subsequently develop hypertension and cardiovascular disease [32][33][34].…”

Section: Introductionmentioning

confidence: 99%

Sex differences in insular gyri responses to the cold pressor challenge

Krause‐Sorio

Macey

Kumar

et al. 2022

Preprint

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Introduction: Sex differences in autonomic control may contribute to physiological sex differences in cardiovascular disease, thermoregulation, and the experience of pain. We previously showed sex differences in functional mapping of autonomic responses across the insula, a central autonomic control region. Anterior insula response patterns to sympathetic activation (Valsalva) and parasympathetic withdrawal (handgrip) differed between men and women. We here assessed sex differences in autonomic insula gyrus responses to a cold pressor challenge, which involves temperature and pain regulation. Methods: Functional MRI (fMRI) involved a 1-minute right-foot cold pressor challenge in 22 women (age; mean±std: 50±4 yrs), and 39 men (45±3 yrs). Regions of interest (ROI) comprised left and right anterior short gyrus (ASG), middle short gyrus (MSG), posterior short gyrus (PSG), anterior long gyrus (ALG), and posterior long gyrus (PLG). Two-second time intervals of fMRI signal responses per ROI and concurrently recorded heart rate and blood oxygen saturation (SaO 2 ) were tested for within- and between-group effects over time (repeated measures ANOVA P ≤0.05). We tested sex differences in 1) each ROI; 2) lateralization effects; and 3) posterior-to-anterior gradients in responses. Results: No sex differences emerged in heart rate or SaO 2 . Women showed larger signal changes in several gyri than men after cold pressor onset and offset. Most consistently, women showed a greater right-over-left hemisphere dominance in cold pressor response compared to men in the MSG, PSG and ALG. Greater right-over-left hemisphere anterior-to-posterior dominance was more pronounced in men. Conclusions: The findings confirm anterior and right-hemispheric dominance of insular responses during sympathetic activation that includes pain and cold. Although distinct transient male-female differences in fMRI responses appeared during the cold pressor, unlike the Valsalva and handgrip, no sex differences in ASG lateralization emerged, suggesting that the previously found sex differences may not solely relate to regulating blood pressure responses.

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Impact of age and sex on neural cardiovascular responsiveness to cold pressor test in humans

Cited by 22 publications

References 55 publications

Sex differences in the vascular response to sympathetic activation during acute hypoxaemia

Sex differences in the vascular response to sympathetic activation during acute hypoxaemia

Treatment of hypertension with angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers and resting metabolic rate: A cross‐sectional study

Sex differences in insular gyri responses to the cold pressor challenge

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