Sex and gender differences in control of blood pressure

Abstract

In recent years the interest in studying the impact of sex steroids and gender on the regulation of blood pressure and cardiovascular disease has been growing. Women are protected from most cardiovascular events compared to men, until after menopause, and postmenopausal women are at increased risk of cardiovascular complications compared to premenopausal women. The pathophysiological mechanisms have not been elucidated but are not likely as simple as the presence or absence of estrogens, since hormone replacement therapy in elderly women in the Women’s Health Initiative or the HERS Trials did not provide primary or secondary prevention against cardiovascular events. Men are also thought to be at risk for cardiovascular disease at earlier ages than women, and these mechanisms too are not likely to be as simple as the presence of testosterone since androgen levels drop in men with cardiovascular and other chronic diseases. In fact, many investigators now believe that it is the reduction in androgen levels that frequently accompanies chronic disease and may exacerbate cardiovascular disease in men. In this review the roles of sex steroids and gender in mediating or protecting against hypertension and cardiovascular disease will be discussed.

Age and sex differences in vascular responsiveness in healthy and trauma patients: contribution of estrogen receptor-mediated Rho kinase and PKC pathways

“…Several studies have shown that premenopausal women are protected from most cardiovascular events as compared with men (26). However, after the menopause, women are at an increased risk of cardiovascular complications as compared with premenopausal women (26). The pathophysiological mechanisms for such differences are not clear, but studies have shown that sex steroids make some contribution (30,36,42).…”

“…Basic and clinical investigations have shown important differences in the structure and function of the cardiovascular system between men and women (32). Several studies have shown that premenopausal women are protected from most cardiovascular events as compared with men (26). However, after the menopause, women are at an increased risk of cardiovascular complications as compared with premenopausal women (26).…”

A 2-month exposure to dietary genistein has sex-dependent effects on serum profile, cardiac protein expression, and aortic morphology in mice

“…[3][4][5] While benefits of soy-based consumption on blood pressure and other parameters of cardiovascular health have been relatively widely described, [6][7][8] the long-term effects of genistein in relevant experimental models remain relatively unclear. We have shown that administering genistein for a period of 2 days by subcutaneous injection at the concentration of 250 mg/kg body weight in the ovariectomized (OVX) rat causes a dose-dependent increase in cardiac output in isolated working hearts and increased ischemic tolerance to reperfusion injury.…”

Effect of aerobic exercise training on cGMP levels and blood pressure in treated hypertensive postmenopausal women

“…Moreover, it has shown that the incidence of CVD in women increases after menopause 15 . It is believed that sex hormones play a major role and estrogen deficiency might be the primary cause of this phenomenon in women in climacteric period; however, most of studies are based on experimental studies, using ovariectomized animals or isolated cells 16 . Although no changes in blood pressure values were found in trained HT group, AET was effective in promoting increase in cardiovascular biomarkers that play a crucial role on BP regulation or oxidative stress modulation.…”