Menstrual Cycle Effects on the Neurohumoral and Autonomic Nervous Systems Regulating the Cardiovascular System

Hirshoren, Nir; Tzoran, Inna; Makrienko, Igor; Edoute, Yehuda; Plawner, Mikahl M.; Itskovitz‐Eldor, Joseph; Jacob, Giris

doi:10.1210/jcem.87.4.8406

Cited by 128 publications

(101 citation statements)

References 33 publications

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“…It has been known that plasma aldosterone and renin activity may oscillate in normal women during the ovarian cycle usually increasing in the luteal phase, [21][22][23][24] but to our knowledge no report has addressed the potential relevance of this aspect in the first-step laboratory screening of primary aldosteronism in low-renin hypertensive women and no recommendation is made on this aspect in the practical guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…Aldosterone levels are known to vary considerably in the same subject and various factors have been identified that affect this variability; among them sodium and potassium balance, posture, circadian rhythm and drug treatment are well known. 19,20 Another determinant of aldosterone variability that has been identified in normal women is the ovarian cycle [21][22][23][24] but this has not so much been taken into account in hypertension.…”

Section: -13mentioning

confidence: 99%

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The ovarian cycle as a factor of variability in the laboratory screening for primary aldosteronism in women

et al. 2008

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Primary aldosteronism is increasingly investigated in hypertension being associated with an elevated cardiovascular risk. Aldosterone has been reported to increase in the luteal phase in normal women but to our knowledge the influence of the ovarian cycle on the first screening for primary aldosteronism (that is, on the levels of plasma aldosterone and its relationship to PRA levels) was never investigated. We measured hormonal levels during one cycle in 26 low-renin mild hypertensive outpatients. LH, FSH, 17 b-estradiol, progesterone, aldosterone and PRA were assayed at the seventh, fourteenth, twenty-first and twenty-eighth days of the cycle after 30 min of recumbency. Aldosterone and PRA increased from the seventh (follicular phase) to twentyfirst day (luteal phase) from 11.2 to 17.8 ng 100 ml À1 and from 0.23 to 0.35 ng ml À1 h À1 , respectively (both P ¼ 0.004) The proportion of patients with aldosterone 415 ng 100 ml À1 significantly increased from the follicular to the luteal phase, (8/26 vs 19/25, P ¼ 0.018); a similar increase was found for Aldosterone-PRA Ratio 430 combined with either a minimum PRA value of 0.5 ng ml À1 h À1 or aldosterone 415 ng 100 ml À1 (7/26 vs 16/25 and 7/26 vs 17/25 respectively, Po0.05).Aldosterone was positively related to PRA and progesterone. Higher aldosterone levels may be frequently encountered in the second part of the ovarian cycle in low-renin hypertensive women. This variability appears to be an important factor to be taken into account in the first-step laboratory screening for primary aldosteronism and should be considered in the process of standardization of the diagnostic work-up for this disease.

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Section: Discussionmentioning

confidence: 99%

Section: -13mentioning

confidence: 99%

The ovarian cycle as a factor of variability in the laboratory screening for primary aldosteronism in women

et al. 2008

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“…A gender difference may be revealed, or perhaps, overestimated, when all women are studied during the follicular phase, at which time sympathetic activity tends to be relatively low. 22,41 Another potential limitation of our study is that some of the women were ingesting oral contraceptive pills. In a previous study, oral contraceptives influenced baroreflex heart rate and sympathetic vasomotor tone regulation.…”

Section: Discussionmentioning

confidence: 99%

Baroreflex Regulation of Heart Rate and Sympathetic Vasomotor Tone in Women and Men

et al. 2005

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Abstract-Gender has been reported to influence baroreflex heart rate regulation and baroreflex blood pressure buffering.We tested the hypothesis that gender influences baroreflex regulation of heart rate and sympathetic vasomotor tone. We recruited 32 normal-weight healthy subjects (17 men and 15 women). ECGs for heart rate, brachial and finger blood pressure, and muscle sympathetic nerve activity (MSNA) were measured. Baroreflex heart rate and MSNA regulation were assessed using incremental phenylephrine and nitroprusside infusions. Baseline blood pressure was similar in men and women. MSNA was 21Ϯ2.5 bursts/min in women and 19Ϯ2.8 bursts/min in men (NS). The gain of the baroreflex MSNA curves was similar in women and men (Ϫ1.9Ϯ0.2 bursts/min per mm Hg in men and Ϫ2.0Ϯ0.3 bursts/min per mm Hg in women). Baroreflex gain for heart rate regulation was 17Ϯ3.2 ms/mm Hg in women and 19Ϯ1.9 ms/mm Hg in men (NS). We conclude that baroreflex gains for heart rate and sympathetic MSNA regulation are similar in women and men. However, the probability for congruence between men and women in terms of the MSNA baroreflex curves was 0.06% for burst rate, 0.4% for burst incidence, and 0.01% for burst area. In women, the MSNA baroreflex curve may be shifted to slightly lower blood pressure such that at a given blood pressure MSNA tends to be lower. Key Words: autonomic nervous system Ⅲ baroreflex Ⅲ gender Ⅲ nervous system, sympathetic T he autonomic nervous system influences blood pressure and heart rate through adjustments in parasympathetic and sympathetic activity. Parasympathetic and sympathetic activities are tightly regulated through baroreflex mechanisms. Therefore, baroreflexes have a pivotal role in shortterm cardiovascular regulation and buffer-excessive blood pressure swings. 1,2 Among numerous other variables, baroreflexes are also involved in long-term blood pressure maintenance. [3][4][5] Even when overall blood pressure regulation is functioning properly, the balance between baroreflex regulation of heart rate and vascular tone may be perturbed. Imbalance between sympathetic activation of the heart and the vasculature has been described in heart failure patients, 6 postural tachycardia syndrome patients, 7,8 and in healthy subjects treated with norepinephrine transporter inhibitors. 9,10 Factors influencing baroreflex function may have an important bearing on human cardiovascular disease. Gender may be such a variable. Previous studies suggest that baroreflex blood pressure buffering is less effective in women than in men. 11 The balance between baroreflex-mediated heart rate and muscle sympathetic nerve activity (MSNA) changes may also be influenced by gender. The idea is supported by the observation that resting sympathetic vasomotor tone tends to be decreased in women, 12,13 whereas resting heart rate is increased. 14 -16 Furthermore, with standing, women showed an exaggerated heart rate and an attenuated sympathetic vasomotor response. 17 Moreover, previous studies suggested that baroreflex heart rate regulati...

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“…Greenberg et al 11 , Hirshoren et al 12 and Pai et al 13 also have demonstrated similar findings. Again, sato et al 1 observed similar results when compared SBP and DBP during follicular and luteal phases of menstrual cycle.…”

Section: Discussionmentioning

confidence: 60%

Sympathetic nerve function status and their relationships with ovarian hormones in healthy young women

Naher

Begum

Ferdousi

2016

J Bangladesh Soc Physiol

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Background: Alteration of sympathetic nerve activity during different phases of menstrual cycle in healthy young women, has been found related with phasic fluctuation of ovarian hormones. Objective: To observe relation of sympathetic nerve function status with estrogen and progesterone during follicular and luteal phases of menstrual cycle in healthy young women. Methods: This cross sectional study was carried out in the Department of physiology of BSMMU, Dhaka from 1 st January to 31 st December 2007. Thirty apparently healthy unmarried women with age 20 to 30 years were selected. Sympathetic nerve function was evaluated by 2 reflex tests, orthostatic test and sustained handgrip, during the three phases of menstrual cycle. Serum estrogen and progesterone were measured during follicular and luteal phases. Data were analyzed by One way ANOVA, an unpaired t test and Pearson's correlation coefficient where applicable. Results: There were no significant significant differences among sympathetic nerve function parameters during three phases of menstrual cycle. Serum estrogen and progesterone showed non significant (p>0.05) relationship with sympathetic nerve function parameters. Conclusion: From this study it may be concluded that sympathetic nerve activity remains unaltered despite fluctuation of ovarian hormones in different phases of menstrual cycle in healthy young women.

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Menstrual Cycle Effects on the Neurohumoral and Autonomic Nervous Systems Regulating the Cardiovascular System

Cited by 128 publications

References 33 publications

The ovarian cycle as a factor of variability in the laboratory screening for primary aldosteronism in women

The ovarian cycle as a factor of variability in the laboratory screening for primary aldosteronism in women

Baroreflex Regulation of Heart Rate and Sympathetic Vasomotor Tone in Women and Men

Sympathetic nerve function status and their relationships with ovarian hormones in healthy young women

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