1
|
17α-ethinylestradiol modulates endothelial function in ovariectomized rat carotid arteries. Eur J Pharmacol 2023; 944:175525. [PMID: 36740036 DOI: 10.1016/j.ejphar.2023.175525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/10/2023] [Accepted: 01/18/2023] [Indexed: 02/05/2023]
Abstract
17α-ethinylestradiol (EE2), a derivative of 17β-estradiol (E2), is a potent estrogenic substance that is used as the estrogenic component of oral contraceptives (OCPs). However, women who take OCPs have an increased risk of cardiovascular events. Since few studies have examined EE2 endothelial effects, we explored the effects of EE2 on endothelial function in ovariectomized and isoflavone-free rats. After ovariectomy, 12-week-old female Sprague-Dawley rats were assigned to EE2, E2 or control groups. After 16 weeks, the EE2 and E2 groups were orally administered EE2 (8.3 μg/day) and E2 (12.6 μg/day) for 4 weeks, respectively. At 18 weeks, endothelial denudation of the left common carotid arteries was performed, and they were harvested at 20 weeks. The rats in the EE2 and E2 groups exhibited significantly decreased body weights and significantly increased uterine weights, respectively, but no differences were observed between the EE2 and E2 groups. The EE2 and E2 groups showed significantly enhanced acetylcholine-induced endothelium-dependent relaxation, with apamin plus charybdotoxin inhibiting only the EE2 group. Endothelial nitric oxide (NO) synthase expression was significantly higher in the EE2 group than in the control, but lower than in the E2 group. The intima-to-media ratio of denuded arteries was significantly lower in the E2 group than in the other groups, suggesting that NO decreased in the EE2 group compared to the E2 group. We conclude that EE2 has a weaker ability than E2 to produce NO and, for the first time, we demonstrate the ability of EE2 to enhance the activity of endothelial-derived hyperpolarizing factor.
Collapse
|
2
|
Assadpour E, Ivry I, Wasef S, Adeyinka B, Murray KR, Edgell H. Oral contraceptives and menstrual cycle influence autonomic reflex function. Physiol Rep 2021; 8:e14550. [PMID: 32889781 PMCID: PMC7507440 DOI: 10.14814/phy2.14550] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 12/31/2022] Open
Abstract
Progesterone and its analogues are known to influence ventilation. Therefore, the purpose of this study was to investigate the role of endogenous and pharmaceutical female sex hormones in ventilatory control during the activation of the metaboreflex, mechanoreflex, and CO2 chemoreflex. Women aged 18–30 taking (n = 14) or not taking (n = 12) oral contraceptives (OC and NOC, respectively) were tested in the low hormone (LH) and high hormone (HH) conditions corresponding to the early follicular and mid‐luteal phases (NOC) or placebo and high‐dose pills (OC). Women underwent three randomized trials: (a) 3 min of passive leg movement (PLM), (b) 2 min of 40% maximal voluntary handgrip exercise followed by 2 min of post‐exercise circulatory occlusion (PECO), and (c) 5 min of breathing 5% CO2. We primarily measured hemodynamics and ventilation. During PLM, the OC group had a smaller pressor response (p = .012). During PECO, the OC group similarly exhibited a smaller pressor response (p = .043) and also exhibited a greater ventilatory response (p = .024). Lastly, in response to breathing 5% CO2, women in the HH phase had a greater ventilatory response (p = .022). We found that OC use attenuates the pressor response to both the metaboreflex and mechanoreflex while increasing the ventilatory response to metaboreflex activation. We also found evidence of an enhanced CO2 chemoreflex in the HH phase. We hypothesize that OC effects are from the chronic upregulation of pulmonary and vascular β‐adrenergic receptors. We further suggest that the increased cyclic progesterone in the HH phase enhances the chemoreflex.
Collapse
Affiliation(s)
- Elnaz Assadpour
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Ilana Ivry
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Sara Wasef
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Baithat Adeyinka
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Kevin R Murray
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Heather Edgell
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| |
Collapse
|
3
|
Eagan LE, Chesney CA, Mascone SE, Shenouda N, Ranadive SM. Interleukin-6 is higher in naturally menstruating women compared with oral contraceptive pill users during the low-hormone phase. J Appl Physiol (1985) 2021; 131:544-552. [PMID: 34138651 DOI: 10.1152/japplphysiol.00921.2020] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Endogenous sex hormone concentrations vary between healthy naturally menstruating (non-OCP) and oral contraceptive pill-using (OCP) women, as well as across cycles. The aim of this study was to investigate potential differences in concentrations of inflammatory cytokine interleukin-6 (IL-6) and vasoconstrictive substance endothelin-1 (ET-1) and measures of vascular function among relatively lower- and higher-hormone phases of non-OCP and OCP women. Concentrations of estrogen, progesterone, IL-6, and ET-1 and measures of vascular function were collected in 22 women (22 ± 1 yr, OCP: n = 12) during the early follicular (EF, ≤5 days of menstruation onset) and early luteal (EL, 4 ± 2 days postovulation) phases of non-OCP subjects and were compared to the placebo pill (PP, ≤5 days of PP onset) and active pill (AP, ≤5 days of highest-dose AP) phases of OCP subjects. Vascular function was assessed via brachial artery flow-mediated dilation (%FMD). Concentrations of endogenous estrogen and progesterone were higher in the EL phase compared with the EF phase of non-OCP (P = 0.01) but were similar between phases of OCP (P > 0.05). IL-6 was higher in non-OCP during the EF phase compared with the EL phase (P = 0.03) as well as compared with OCP during the PP phase (P = 0.002) but was similar between groups during the EL and AP phases, respectively (P > 0.05). Concentrations of ET-1 and measures of %FMD were similar between groups and unaffected by phase (P > 0.05). Thus, there exists variation in inflammation between young, healthy non-OCP and OCP women during the lower-hormone phase, despite similarities in vascular function and concentrations of ET-1 between groups and phases.NEW & NOTEWORTHY We demonstrate that despite having similar macrovascular function and concentrations of the vasoconstrictive substance endothelin-1 (ET-1) healthy naturally menstruating women display higher concentrations of circulating IL-6 during the lower-hormone phase of their menstrual cycle compared with 1) the higher-hormone phase of their menstrual cycle and 2) the lower-hormone phase of healthy women using oral contraceptive pills.
Collapse
Affiliation(s)
- Lauren E Eagan
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland
| | - Catalina A Chesney
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland
| | - Sara E Mascone
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland
| | - Ninette Shenouda
- Department of Kinesiology and Applied Physiology, College of Health Sciences, University of Delaware, Newark, Delaware
| | - Sushant M Ranadive
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland
| |
Collapse
|
4
|
Turner CG, Stanhewicz AE, Wong BJ. Female Sex Hormone Effects on the Vasculature: Considering the Validity of Restricting Study Inclusion to Low-Hormone Phases. Front Physiol 2020; 11:596507. [PMID: 33192613 PMCID: PMC7652897 DOI: 10.3389/fphys.2020.596507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 10/07/2020] [Indexed: 11/26/2022] Open
Abstract
Many studies of vascular function limit the testing of premenopausal female participants to periods when female sex hormones, either endogenous or exogenous, are at their lowest concentration. This practice, when not part of the specific research question, may limit data surrounding the predominant physiological state of premenopausal females and pose a threat to external validity. In this Perspective, we briefly review the literature on the effect of female sex hormones on vascular function and discuss when limiting experimental testing to a certain phase of the menstrual cycle (MC) or oral contraceptive (OC) use may be appropriate. The goal of this Perspective is to open a dialog that may enhance data validity and the overall understanding of vascular function in premenopausal females.
Collapse
Affiliation(s)
- Casey G Turner
- Cutaneous Microvascular and Sensory Nerve Function Laboratory, Department of Kinesiology and Health, Georgia State University, Atlanta, GA, United States
| | - Anna E Stanhewicz
- Microvascular Physiology Laboratory, Department of Health and Human Physiology, University of Iowa, Iowa City, IA, United States
| | - Brett J Wong
- Cutaneous Microvascular and Sensory Nerve Function Laboratory, Department of Kinesiology and Health, Georgia State University, Atlanta, GA, United States
| |
Collapse
|
5
|
Williams JS, MacDonald MJ. Influence of hormonal contraceptives on peripheral vascular function and structure in premenopausal females: a review. Am J Physiol Heart Circ Physiol 2020; 320:H77-H89. [PMID: 33164574 DOI: 10.1152/ajpheart.00614.2020] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Hormonal contraceptives are one of the most widely used prescriptions for premenopausal women worldwide. Although the risk of venous and arterial cardiovascular events (e.g., deep vein thrombosis, arterial clotting) with hormonal contraceptives, specifically oral contraceptive pills, has been established, the literature on early risk indicators, such as peripheral vascular structure and function has yet to be consolidated. The purpose of this review is to summarize literature examining the impact of different hormonal contraceptives on vascular function and structure, including consideration of phasic differences within a contraceptive cycle, and to propose future directions for research. It is evident that hormonal contraceptive use appears to impact both macrovascular and microvascular endothelial function, with phasic differences in some contraceptive types dependent on progestin type, the ratio of ethinyl estradiol-to-progestin, and route of administration. However, hormonal contraceptives do not appear to impact smooth muscle function in the macrovasculature or microvasculature, arterial stiffness, or vascular structure. Underlying mechanisms for observed impacts and areas of future research are discussed. This review provides timely consolidation of research examining hormonal contraceptives and peripheral vascular function and structure and provides guidance on considerations for hormonal contraceptive use in study design.
Collapse
Affiliation(s)
- Jennifer S Williams
- Vascular Dynamics Laboratory, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Maureen J MacDonald
- Vascular Dynamics Laboratory, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
6
|
O’Brien MW, Johns JA, Al-Hinnawi A, Kimmerly DS. Popliteal flow-mediated dilatory responses to an acute bout of prolonged sitting between earlier and later phases of natural menstrual and oral contraceptive pill cycles. J Appl Physiol (1985) 2020; 129:637-645. [DOI: 10.1152/japplphysiol.00424.2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
We compared changes in popliteal artery endothelial function to a 3-h bout of sitting in females across their natural menstrual or oral contraceptive pill cycles. Pre-sitting endothelial-dependent vasodilation was greater in females who naturally menstruate during the later versus earlier phase but unchanged among contraceptive pill phases. Neither menstrual nor oral contraceptive pill phases attenuated the robust decline in conduit artery health following an acute period of uninterrupted sitting in young females.
Collapse
Affiliation(s)
- Myles W. O’Brien
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jarrett A. Johns
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Amera Al-Hinnawi
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Derek S. Kimmerly
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
7
|
Williams JS, Stimpson TV, Tremblay JC, Fenuta AM, Pyke KE. The influence of acute hyperglycaemia on brachial artery flow-mediated dilatation in the early and late follicular phases of the menstrual cycle. Exp Physiol 2019; 104:957-966. [PMID: 30927376 DOI: 10.1113/ep087536] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/29/2019] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of the study? This is the first study to examine the impact of acute hyperglycaemia on endothelial function [flow-mediated dilatation (FMD)] in premenopausal women across the early and late follicular (EF and LF) phases of the menstrual cycle. What is the main finding and its importance? Flow-mediated dilatation was impaired 90 min after glucose ingestion, with no significant difference between phases. This indicates that women are susceptible to acute hyperglycaemia-induced endothelial dysfunction in both the EF and LF phases of the menstrual cycle, despite potentially vasoprotective elevations in estradiol levels during the LF phase. ABSTRACT Acute hyperglycaemia transiently impairs endothelial function in healthy men when assessed via flow-mediated dilatation (FMD). However, research in female participants is lacking, and the impact of menstrual phase [early follicular (EF) and late follicular (LF)] on vulnerability to acute hyperglycaemia-induced endothelial dysfunction is unknown. Seventeen healthy, naturally menstruating women [21 ± 1 years old (mean ± SD)] participated in three visits. During two visits (EFGlucose and LFGlucose ), brachial artery FMD was assessed before and 60, 90 and 120 min after an oral glucose challenge (75 g glucose). During an additional EF visit, participants ingested 300 ml of water (EFTimeControl ). Blood glucose and insulin increased 30 min after glucose ingestion (P < 0.001), with no difference between phases. Flow-mediated dilatation did not change in EFTimeControl (P = 0.748) but was reduced 90 min after glucose ingestion (Pre, 8.5 ± 2.5%; Post90, 6.6 ± 2.4%, P = 0.001; Cohen's d = 0.82), with no difference between phases (main effect of phase, P = 0.506; phase by time interaction, P = 0.391). To account for individual variability in the time course of the impact of hyperglycaemia, the maximal hyperglycaemia-induced impairment in FMD was determined in each participant and compared between phases, revealing no significant phase differences (EFGlucose , -3.1 ± 2.8%; LFGlucose , -2.4 ± 2.1%, P = 0.181; d = 0.34). These results indicate that, similar to findings in men, acute hyperglycaemia results in FMD impairment in young women. We did not detect significant protection from acute hyperglycaemia-induced endothelial dysfunction in the LF 'high-oestrogen' phase in this sample, and further research is needed to examine the potential for a protective effect of oestrogen exposure, including oral contraceptive pills and hormone replacement therapy.
Collapse
Affiliation(s)
- Jennifer S Williams
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Taylor V Stimpson
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Joshua C Tremblay
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Alyssa M Fenuta
- Human Vascular Control Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Kyra E Pyke
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| |
Collapse
|
8
|
Cyr MP, Pinard A, Dubois O, Morin M. Reliability of vulvar blood perfusion in women with provoked vestibulodynia using laser Doppler perfusion imaging and laser speckle imaging. Microvasc Res 2019; 121:1-6. [DOI: 10.1016/j.mvr.2018.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 06/12/2018] [Accepted: 08/08/2018] [Indexed: 11/29/2022]
|
9
|
Shenouda N, Priest SE, Rizzuto VI, MacDonald MJ. Brachial artery endothelial function is stable across a menstrual and oral contraceptive pill cycle but lower in premenopausal women than in age-matched men. Am J Physiol Heart Circ Physiol 2018; 315:H366-H374. [DOI: 10.1152/ajpheart.00102.2018] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Sex hormone concentrations differ between men, premenopausal women with natural menstrual cycles (NAT), and premenopausal women using oral contraceptive pills (OCP), as well as across menstrual or OCP phases. This study sought to investigate how differences in sex hormones, particularly estradiol, between men and women and across cycle phases might influence brachial artery endothelial function. Fifty-three healthy adults (22 ± 3 yr, 20 men, 15 NAT women, and 18 second-, third-, or fourth-generation OCP women) underwent assessments of sex hormones and endothelial [flow-mediated dilation (FMD) test] and smooth muscle [nitroglycerin (NTG) test] function. Men were tested three times at 1-wk intervals, and women were tested three times throughout a single menstrual or OCP cycle (NAT: menstrual, midfollicular, and luteal phases and OCP: placebo/no pill, “early”, and “late” active pill phases). Endogenous estradiol concentration was comparable between men and women in their NAT menstrual or OCP placebo phase ( P = 0.36) but increased throughout a NAT cycle ( P < 0.001). Allometrically scaled FMD did not change across a NAT or OCP cycle but was lower in both groups of women than in men ( P = 0.005), whereas scaled NTG was lower only in NAT women ( P = 0.001). Changes in estradiol across a NAT cycle were not associated with changes in relative FMD ( r2 = 0.01, P = 0.62) or NTG ( r2 = 0.09, P = 0.13). Duration of OCP use was negatively associated with the average relative FMD for second-generation OCP users only ( r = −0.65, P = 0.04). Our findings suggest that brachial endothelial function is unaffected by cyclic hormonal changes in premenopausal women but may be negatively impacted by longer-term use of second-generation OCPs. NEW & NOTEWORTHY We demonstrate that brachial artery flow-mediated dilation does not change across a menstrual or oral contraceptive pill cycle in premenopausal women but is lower in women than in men. Although unaffected by within-cycle changes in estradiol, brachial flow-mediated dilation is negatively correlated with duration of oral contraceptive pill use for second-generation pills. Listen to this article’s corresponding podcast at https://ajpheart.podbean.com/e/behind-the-bench-episode-2/ .
Collapse
Affiliation(s)
- Ninette Shenouda
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Stacey E. Priest
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Vanessa I. Rizzuto
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | | |
Collapse
|
10
|
Sebzda KN, Kuczmarski AV, Pohlig RT, Lennon SL, Edwards DG, Wenner MM. Ovarian hormones modulate endothelin-1 receptor responses in young women. Microcirculation 2018; 25:e12490. [PMID: 29999581 DOI: 10.1111/micc.12490] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/30/2018] [Accepted: 07/10/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE We recently demonstrated ETBR mediate vasodilation in young but not postmenopausal women; it is unclear if this is related to age or a decline in ovarian hormones. The purpose of this study was to test the hypothesis that ETBR responses are modulated by ovarian hormones. METHODS We measured cutaneous vasodilatory responses in 12 young women (22 ± 1 years, 23 ± 1 kg/m2 ) during the ML (days 20-25) and EF (days 2-5) phases of the menstrual cycle. Cutaneous microdialysis perfusions of lactated Ringer (control), ETBR antagonist (BQ-788, 300 nmol/L), and ETAR antagonist (BQ-123, 500 nmol/L) were performed, followed by local heating to 42°C. RESULTS Serum estradiol (ML: 118 ± 16 vs EF: 44 ± 9 pg/mL, P < 0.05) and progesterone (ML: 8.3 ± 1.0 vs EF: 0.7 ± 0.2 ng/mL, P < 0.05) were higher during ML vs EF phase. ETBR blockade decreased vasodilation during ML (control: 91 ± 2 vs BQ-788: 83 ± 2%CVCmax, P < 0.05) but not EF (control: 89 ± 2 vs BQ-788: 89 ± 1%CVCmax). ETAR blockade also decreased vasodilation during ML (control: 91 ± 2 vs BQ-123: 87 ± 2%CVCmax, P < 0.05) but not EF (control: 89 ± 2 vs BQ-123: 92 ± 2%CVCmax). CONCLUSIONS These data suggest that fluctuations in ovarian hormones modulate ETBR and ETAR responses in young women.
Collapse
Affiliation(s)
- Kelly N Sebzda
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware
| | - Andrew V Kuczmarski
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware
| | - Ryan T Pohlig
- Biostatistic Core Facility, College of Health Sciences, University of Delaware, Newark, Delaware
| | - Shannon L Lennon
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware
| | - David G Edwards
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware
| | - Megan M Wenner
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware
| |
Collapse
|
11
|
Wenner MM, Sebzda KN, Kuczmarski AV, Pohlig RT, Edwards DG. ET B receptor contribution to vascular dysfunction in postmenopausal women. Am J Physiol Regul Integr Comp Physiol 2017; 313:R51-R57. [PMID: 28438762 DOI: 10.1152/ajpregu.00410.2016] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 03/27/2017] [Accepted: 04/20/2017] [Indexed: 01/05/2023]
Abstract
Endothelin-1 (ET-1) contributes to age-related endothelial dysfunction in men via the ETA receptor. However, there are sex differences in the ET-1 system, and ETB receptors are modulated by sex hormones. The purpose of this study was to test the hypothesis that ETB receptors contribute to impaired vasodilatory function in postmenopausal women (PMW). We measured flow-mediated dilation (FMD) using ultrasound, and cutaneous nitric oxide-mediated vasodilation during local heating (42°C) via laser Doppler flowmetry in 18 young women (YW; 22 ± 1 yr) and 16 PMW (56 ± 1 yr). Cutaneous microdialysis perfusions of lactated Ringer (control), an ETB receptor antagonist (BQ-788, 300 nM), and an ETA receptor antagonist (BQ-123, 500 nM), were done through separate fibers, followed by perfusions of sodium nitroprusside (28 mM) and local heating to 43°C (max). Cutaneous vascular conductance (CVC) was calculated as cutaneous blood flow/mean arterial pressure and expressed as a percent of maximal dilation. FMD (YW: 7.5 ± 0.5 vs. PMW: 5.6 ± 0.6%) and cutaneous vasodilation (YW: 93 ± 2 vs. PMW: 83 ± 4%CVCmax) were lower in PMW (both P < 0.05). Blockade of ETB receptors decreased cutaneous vasodilation in YW (87 ± 2%CVCmax; P < 0.05 vs. control) but increased vasodilation in PMW (93 ± 1%CVCmax; P < 0.05 vs. control). ETA receptor blockade had minimal effect in YW (92 ± 1%CVCmax) but increased cutaneous vasodilation in PMW (91 ± 2%CVCmax; P < 0.05 vs. control). In conclusion, ETB receptors mediate vasodilation in YW, but this effect is lost after menopause. Impaired vasodilatory function in PMW is due in part to a loss of ETB-mediated dilation.
Collapse
Affiliation(s)
- Megan M Wenner
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware; and
| | - Kelly N Sebzda
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware; and
| | - Andrew V Kuczmarski
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware; and
| | - Ryan T Pohlig
- Biostatistics Core Facility, College of Health Sciences, University of Delaware, Newark, Delaware
| | - David G Edwards
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware; and
| |
Collapse
|
12
|
Borgo MV, Claudio ERG, Silva FB, Romero WG, Gouvea SA, Moysés MR, Santos RL, Almeida SA, Podratz PL, Graceli JB, Abreu GR. Hormonal therapy with estradiol and drospirenone improves endothelium-dependent vasodilation in the coronary bed of ovariectomized spontaneously hypertensive rats. ACTA ACUST UNITED AC 2016; 49:e4655. [PMID: 26577845 PMCID: PMC4678653 DOI: 10.1590/1414-431x20154655] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 06/29/2015] [Indexed: 02/07/2023]
Abstract
Drospirenone (DRSP) is a progestin with anti-aldosterone properties and it reduces
blood pressure in hypertensive women. However, the effects of DRSP on
endothelium-dependent coronary vasodilation have not been evaluated. This study
investigated the effects of combined therapy with estrogen (E2) and DRSP on
endothelium-dependent vasodilation of the coronary bed of ovariectomized (OVX)
spontaneously hypertensive rats. Female spontaneously hypertensive rats (n=87) at 12
weeks of age were randomly divided into sham operated (Sham), OVX, OVX treated with
E2 (E2), and OVX treated with E2 and DRSP (E2+DRSP) groups. Hemodynamic parameters
were directly evaluated by catheter insertion into the femoral artery.
Endothelium-dependent vasodilation in response to bradykinin in the coronary arterial
bed was assessed using isolated hearts according to a modified Langendorff method.
Coronary protein expression of endothelial nitric oxide synthase and estrogen
receptor alpha (ER-α) was assessed by Western blotting. Histological slices of
coronary arteries were stained with hematoxylin and eosin, and morphometric
parameters were analyzed. Oxidative stress was assessed in situ by
dihydroethidium fluorescence. Ovariectomy increased systolic blood pressure, which
was only prevented by E2+DRSP treatment. Estrogen deficiency caused endothelial
dysfunction, which was prevented by both treatments. However, the vasodilator
response in the E2+DRSP group was significantly higher at the three highest
concentrations compared with the OVX group. Reduced ER-α expression in OVX rats was
restored by both treatments. Morphometric parameters and oxidative stress were
augmented by OVX and reduced by E2 and E2+DRSP treatments. Hormonal therapy with E2
and DRSP may be an important therapeutic option in the prevention of coronary heart
disease in hypertensive post-menopausal women.
Collapse
Affiliation(s)
- M V Borgo
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal de Espírito Santo, Vitória, ES, Brasil
| | - E R G Claudio
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal de Espírito Santo, Vitória, ES, Brasil
| | - F B Silva
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal de Espírito Santo, Vitória, ES, Brasil
| | - W G Romero
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal de Espírito Santo, Vitória, ES, Brasil
| | - S A Gouvea
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal de Espírito Santo, Vitória, ES, Brasil
| | - M R Moysés
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal de Espírito Santo, Vitória, ES, Brasil
| | - R L Santos
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal de Espírito Santo, Vitória, ES, Brasil
| | - S A Almeida
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal de Espírito Santo, Vitória, ES, Brasil
| | - P L Podratz
- Departamento de Morfologia, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - J B Graceli
- Departamento de Morfologia, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - G R Abreu
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal de Espírito Santo, Vitória, ES, Brasil
| |
Collapse
|
13
|
Usselman CW, Nielson CA, Luchyshyn TA, Gimon TI, Coverdale NS, Van Uum SHM, Shoemaker JK. Hormone phase influences sympathetic responses to high levels of lower body negative pressure in young healthy women. Am J Physiol Regul Integr Comp Physiol 2016; 311:R957-R963. [PMID: 27733385 DOI: 10.1152/ajpregu.00190.2016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 09/28/2016] [Accepted: 10/11/2016] [Indexed: 01/03/2023]
Abstract
We tested the hypothesis that sympathetic responses to baroreceptor unloading may be affected by circulating sex hormones. During lower body negative pressure at -30, -60, and -80 mmHg, muscle sympathetic nerve activity (MSNA), heart rate, and blood pressure were recorded in women who were taking (n = 8) or not taking (n = 9) hormonal contraceptives. All women were tested twice, once during the low-hormone phase (i.e., the early follicular phase of the menstrual cycle and the placebo phase of hormonal contraceptive use), and again during the high-hormone phase (i.e., the midluteal phase of the menstrual cycle and active phase of contraceptive use). During baroreceptor unloading, the reductions in stroke volume and resultant increases in MSNA and total peripheral resistance were greater in high-hormone than low-hormone phases in both groups. When normalized to the fall in stroke volume, increases in MSNA were no longer different between hormone phases. While stroke volume and sympathetic responses were similar between women taking and not taking hormonal contraceptives, mean arterial pressure was maintained during baroreceptor unloading in women not taking hormonal contraceptives but not in women using hormonal contraceptives. These data suggest that differences in sympathetic activation between hormone phases, as elicited by lower body negative pressure, are the result of hormonally mediated changes in the hemodynamic consequences of negative pressure, rather than centrally driven alterations to sympathetic regulation.
Collapse
Affiliation(s)
- Charlotte W Usselman
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, Ontario, Canada
| | - Chantelle A Nielson
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, Ontario, Canada
| | - Torri A Luchyshyn
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, Ontario, Canada
| | - Tamara I Gimon
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, Ontario, Canada
| | - Nicole S Coverdale
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, Ontario, Canada
| | - Stan H M Van Uum
- Department of Medicine, Western University, London, Ontario, Canada.,Lawson Health Research Institute, Western University, London, Ontario, Canada; and
| | - J Kevin Shoemaker
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, Ontario, Canada; .,Department of Physiology and Pharmacology, Western University, London, Ontario, Canada
| |
Collapse
|
14
|
Limberg JK, Peltonen GL, Johansson RE, Harrell JW, Kellawan JM, Eldridge MW, Sebranek JJ, Walker BJ, Schrage WG. Greater Beta-Adrenergic Receptor Mediated Vasodilation in Women Using Oral Contraceptives. Front Physiol 2016; 7:215. [PMID: 27375493 PMCID: PMC4896959 DOI: 10.3389/fphys.2016.00215] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 05/23/2016] [Indexed: 11/25/2022] Open
Abstract
Background: β-adrenergic receptors play an important role in mitigating the pressor effects of sympathetic nervous system activity in young women. Based on recent data showing oral contraceptive use in women abolishes the relationship between muscle sympathetic nervous system activity and blood pressure, we hypothesized forearm blood flow responses to a β-adrenergic receptor agonist would be greater in young women currently using oral contraceptives (OC+, n = 13) when compared to those not using oral contraceptives (OC–, n = 10). Methods: Women (18–35 years) were studied during the early follicular phase of the menstrual cycle (days 1–5) or placebo phase of oral contraceptive use. Forearm blood flow (FBF, Doppler ultrasound) and mean arterial blood pressure (MAP, brachial arterial catheter) were measured at baseline and during graded brachial artery infusion of the β-adrenergic receptor agonist, Isoproterenol (ISO), as well as Acetylcholine (ACH, endothelium-dependent vasodilation) and Nitroprusside (NTP, endothelium-independent vasodilation). Forearm vascular conductance was calculated (FVC = FBF/MAP, ml/min/100 mmHg) and the rise in FVC from baseline during infusion quantified vasodilation (ΔFVC = FVCinfusion − FVCbaseline). Results: ISO increased FVC in both groups (p < 0.01) and ISO-mediated ΔFVC was greater in OC+ compared to OC– (Main effect of group, p = 0.02). Expressing data as FVC and FBF resulted in similar conclusions. FVC responses to both ACH and NTP were also greater in OC+ compared to OC–. Conclusions: These data are the first to demonstrate greater β-adrenergic receptor-mediated vasodilation in the forearm of women currently using oral contraceptives (placebo phase) when compared to those not using oral contraceptives (early follicular phase), and suggest oral contraceptive use influences neurovascular control.
Collapse
Affiliation(s)
| | | | | | - John W Harrell
- Department of Kinesiology, University of Wisconsin Madison, WI, USA
| | | | - Marlowe W Eldridge
- Department of Kinesiology, University of WisconsinMadison, WI, USA; Department of Pediatrics, University of WisconsinMadison, WI, USA
| | - Joshua J Sebranek
- Department of Anesthesiology, University of Wisconsin Madison, WI, USA
| | - Benjamin J Walker
- Department of Anesthesiology, University of Wisconsin Madison, WI, USA
| | | |
Collapse
|
15
|
Usselman CW, Luchyshyn TA, Gimon TI, Nielson CA, Van Uum SHM, Shoemaker JK. Hormone phase dependency of neural responses to chemoreflex-driven sympathoexcitation in young women using hormonal contraceptives. J Appl Physiol (1985) 2013; 115:1415-22. [PMID: 24009009 DOI: 10.1152/japplphysiol.00681.2013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Hormone fluctuations in women may influence muscle sympathetic nerve activity (MSNA) in a manner dependent on the severity of the sympathoexcitatory stimulus. This study examined MSNA patterns at rest and during chemoreflex stimulation in low- (LH) vs. high-hormone (HH) phases of contraceptive use in healthy young women (n = 7). We tested the hypothesis that MSNA would be greater in the HH phase at baseline and in response to chemoreflex stimulation. MSNA recordings were obtained through microneurography in LH and HH at baseline, during rebreathing causing progressive hypoxia and hypercapnia, and during a hypercapnic-hypoxic end-inspiratory apnea. Baseline MSNA burst incidence (P = 0.03) and burst frequency (P = 0.02) were greater in the HH phase, while MSNA burst amplitude distributions and hemodynamic measures were similar between phases. Rebreathing elicited increases in all MSNA characteristics from baseline (P < 0.05), but was not associated with hormone phase-dependent changes to MSNA patterns. Apnea data were considered in two halves, both of which caused large increases in all MSNA variables from baseline in each hormone phase (P < 0.01). Increases in burst incidence and frequency were greater in LH during the first half of the apnea (P = 0.03 and P = 0.02, respectively), while increases in burst amplitude and total MSNA were greater in LH during the second half of the apnea (P < 0.05). These results indicate that change in hormone phase brought on through use of hormonal contraceptives influences MSNA patterns such that baseline MSNA is greater in the HH phase, but responses to severe chemoreflex stimulation are greater in the LH phase.
Collapse
Affiliation(s)
- Charlotte W Usselman
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, Ontario, Canada
| | | | | | | | | | | |
Collapse
|
16
|
Goswami N, Gorur P, Pilsl U, Anyaehie B, Green DA, Bondarenko AI, Roessler A, Hinghofer-Szalkay HG. Effect of orthostasis on endothelial function: a gender comparative study. PLoS One 2013; 8:e71655. [PMID: 24147147 PMCID: PMC3798144 DOI: 10.1371/journal.pone.0071655] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 07/01/2013] [Indexed: 01/22/2023] Open
Abstract
As the vascular endothelium has multiple functions, including regulation of vascular tone, it may play a role in the pathophysiology of orthostatic intolerance. We investigated the effect of orthostasis on endothelial function using EndoPAT®, a non-invasive and user-independent method, and across gender. As sex steroid hormones are known to affect endothelial function, this study examined the potential effect of these hormones on the endothelial response to orthostasis by including females at different phases of the menstrual cycle (follicular and luteal—where the hormone balance differs), and females taking an oral contraceptive. A total of 31 subjects took part in this study (11 males, 11 females having normal menstrual cycles and 9 females taking oral contraceptive). Each subject made two visits for testing; in the case of females having normal menstrual cycles the first session was conducted either 1–7 (follicular) or 14–21 days (luteal) after the start of menstruation, and the second session two weeks later, i.e., during the other phase, respectively. Endothelial function was assessed at baseline and following a 20-min orthostatic challenge (active standing). The EndoPAT® index increased from 1.71 ± 0.09 (mean ± SEM) at baseline to 2.07 ± 0.09 following orthostasis in females (p<0.001). In males, the index increased from 1.60 ± 0.08 to 1.94 ± 0.13 following orthostasis (p<0.001). There were no significant differences, however, in the endothelial response to orthostasis between females and males, menstrual cycle phases and the usage of oral contraceptive. Our results suggest an increased vasodilatatory endothelial response following orthostasis in both females and males. The effect of gender and sex hormones on the endothelial response to orthostasis appears limited. Further studies are needed to determine the potential role of this post orthostasis endothelial response in the pathophysiology of orthostatic intolerance.
Collapse
Affiliation(s)
- Nandu Goswami
- Institute of Physiology, Center of Physiological Medicine, Medical University of Graz, Graz, Austria
- * E-mail:
| | - Paavan Gorur
- Centre of Human and Aerospace Physiological Sciences, King’s College London, London, United Kingdom
| | - Ulrike Pilsl
- Department of Anatomy, Medical University of Graz, Graz, Austria
| | - Bond Anyaehie
- Department of Physiology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - David A. Green
- Centre of Human and Aerospace Physiological Sciences, King’s College London, London, United Kingdom
| | | | - Andreas Roessler
- Institute of Physiology, Center of Physiological Medicine, Medical University of Graz, Graz, Austria
| | | |
Collapse
|
17
|
Selim MF, Hussein AF. Endothelial function in women using levonorgestrel-releasing intrauterine system (LNG-IUS). Contraception 2013; 87:396-403. [DOI: 10.1016/j.contraception.2012.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 12/02/2012] [Accepted: 12/14/2012] [Indexed: 10/27/2022]
|
18
|
Nelson AL. Comprehensive evaluation of Safyral(®) 2012. WOMENS HEALTH 2012. [PMID: 23181528 DOI: 10.2217/whe.12.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The incidence of pregnancies affected with neural tube defects (NTDs) has been reduced by food fortification programs and public health campaigns promoting folic acid supplementation, but the incidence of NTDs in the USA has not achieved the full potential reduction expected with adequate periconceptional folate utilization. In seeking new ways to access sexually active women at risk for pregnancy, one option would be to link folic acid supplementation to contraceptive use. Since birth control pills are the most popular method of reversible contraception in the USA, it would seem quite logical to find a way to supplement them. To this end, a very efficient folate, levomefolate calcium salt (metafolin), has been added to drospirenone-containing oral contraceptives in equimolar concentrations to the recommended supplements of folic acid to reduce the risk for pregnancy and to reduce the risk of NTDs in pregnancies that occur while women are taking the pill or shortly after they discontinue its use. This article will focus on the need for such folate supplementation and will summarize the contraceptive and noncontraceptive benefits of the 30 µg EE/3 mg drospirenone pill (Yasmin(®), Bayer Healthcare, NJ, USA) to which has been added 451 metafolin (Safyral(®), Bayer Healthcare). The new information about thromboembolism risks associated with use of drospirenone-containing pills is also discussed.
Collapse
|
19
|
Carter JR, Fu Q, Minson CT, Joyner MJ. Ovarian cycle and sympathoexcitation in premenopausal women. Hypertension 2012; 61:395-9. [PMID: 23172932 DOI: 10.1161/hypertensionaha.112.202598] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The influence of the ovarian cycle on muscle sympathetic nerve activity (MSNA) remains controversial. Some studies report an increase of resting MSNA during the mid luteal (ML) phase of the ovarian cycle compared with the early follicular phase, whereas other studies do not. These inconsistent findings may be attributable, in part, to the variable surges in estradiol and progesterone. We tested the hypothesis that the degree of sympathoexcitation during the ML phase (ΔMSNA) is associated with changes in estradiol (ΔE(2)) and progesterone (ΔP). Multiple regression analysis of data from previous studies with complete recordings of mean arterial pressure, MSNA, E(2), and P during both early follicular and ML phases were available from 30 eumenorrheic women (age, 28 ± 1 years; body mass index, 23 ± 0 kg/m(2)). ML phase increased E(2) (37 ± 2 to 117 ± 9 pg/mL; P<0.001), P (1 ± 0 to 11 ± 1 ng/mL; P<0.001), and MSNA (12 ± 1 to 15 ± 1 bursts/min; P=0.02), but did not alter mean arterial pressure (83 ± 2 to 83 ± 2 mm Hg; P=0.91). ΔMSNA was correlated with ΔE(2) (r=-0.50, P=0.003) and ΔE(2)/ΔP (r=-0.52, P=0.002) but not ΔP (r=0.21, P=0.13). There was no association between Δmean arterial pressure and ΔE(2) (r=-0.13, P=0.49), ΔP (r=-0.04, P=0.83), or ΔE(2)/ΔP (r<0.01, P=0.98). In conclusion, sympathoexcitation during the ML phase of the ovarian cycle seems to be dependent, in part, on the degree of sex steroid surges. This dynamic interaction among E(2), P, and MSNA likely explains previously reported inconsistencies in the field; it remains possible that other sex steroids, such as testosterone, might explain further variance.
Collapse
Affiliation(s)
- Jason R Carter
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, 1400 Townsend Drive, Houghton, MI 49931, USA.
| | | | | | | |
Collapse
|
20
|
Giribela CR, Melo NR, Silva RC, Hong VM, Guerra GM, Baracat EC, Consolim-Colombo FM. A combined oral contraceptive containing drospirenone changes neither endothelial function nor hemodynamic parameters in healthy young women: a prospective clinical trial. Contraception 2012; 86:35-41. [DOI: 10.1016/j.contraception.2011.08.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2011] [Revised: 08/22/2011] [Accepted: 08/24/2011] [Indexed: 11/29/2022]
|
21
|
Ilie IR, Marian I, Mocan T, Ilie R, Mocan L, Duncea I, Pepene CE. Ethinylestradiol30μg-drospirenone and metformin: could this combination improve endothelial dysfunction in polycystic ovary syndrome? BMC Endocr Disord 2012; 12:9. [PMID: 22713099 PMCID: PMC3413550 DOI: 10.1186/1472-6823-12-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 06/19/2012] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND We are hereby investigating for the first time the effect of the association ethinylestradiol30μg-drospirenone 3mg (DRP/EE30μg) plus metformin and weight loss on endothelial status and C-reactive protein (hsCRP) levels in polycystic ovary syndrome (PCOS). METHODS 25 young women with PCOS (mean age 22.76 ± 0.83 years, body mass index (BMI): 28.44 ± 6.23) who completed the study were prospectively evaluated. The oral contraceptive- DRP/EE30μg (21 days/month) and metformin (1700 mg daily) were administered for 6 months to the PCOS group. Additionally, the 15 overweight and obese patients (BMI > 25 kg/m2) were instructed in a diet of no more than 1500 cal daily. Primary outcome measures were surrogate markers of cardiovascular disease and included endothelial function, i.e. flow-mediated dilatation (FMD) on the brachial artery and endothelin-1 levels, as well as hsCRP concentrations, body composition (measured by whole-body dual-energy X-ray-absorptiometry) and insulin resistance. Variables were assessed at baseline, as well as after our medical intervention. RESULTS The combination between DRP/EE30μg plus metformin combined with weight loss triggered a significant improvement in the FMD values (FMD-PCOSbasal 3.48 ± 1.00 vs FMD-PCOS6 months7.43 ± 1.04, p = 0.033), as well as body composition and insulin insensitivity (p < 0.05). Regarding hsCRP levels, there was no significant intragroup (PCOS6months - PCOSbasal) difference. CONCLUSION A 6-month course of metformin- DRP/EE30μg (associated with weight loss) improves the endothelial dysfunction in PCOS and shows neutral effects on hsCRP concentrations as an inflammation marker. These data demand for reevaluation of the medical therapy in PCOS, particularly in women with additional metabolic and cardiovascular risk factors (ClinicalTrials.gov Identifier: NCT01459445).
Collapse
Affiliation(s)
- Ioana Rada Ilie
- Department of Endocrinology, University of Medicine and Pharmacy, 3-5 Louis Pasteur, 400349, Cluj-Napoca, Romania
| | - Ioan Marian
- Department of Internal Medicine-Cardiology, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Teodora Mocan
- Departmen of Physiology, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Razvan Ilie
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Lucian Mocan
- 3-rd Department of Surgery, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ileana Duncea
- Department of Endocrinology, University of Medicine and Pharmacy, 3-5 Louis Pasteur, 400349, Cluj-Napoca, Romania
| | - Carmen Emanuela Pepene
- Department of Endocrinology, University of Medicine and Pharmacy, 3-5 Louis Pasteur, 400349, Cluj-Napoca, Romania
| |
Collapse
|
22
|
Abstract
Men have higher blood pressure than women through much of life regardless of race and ethnicity. This is a robust and highly conserved sex difference that it is also observed across species including dogs, rats, mice and chickens and it is found in induced, genetic and transgenic animal models of hypertension. Not only do the differences between the ovarian and testicular hormonal milieu contribute to this sexual dimorphism in blood pressure, the sex chromosomes also play a role in and of themselves. This review primarily focuses on epidemiological studies of blood pressure in men and women and experimental models of hypertension in both sexes. Gaps in current knowledge regarding what underlie male-female differences in blood pressure control are discussed. Elucidating the mechanisms underlying sex differences in hypertension may lead to the development of anti-hypertensives tailored to one's sex and ultimately to improved therapeutic strategies for treating this disease and preventing its devastating consequences.
Collapse
Affiliation(s)
- Kathryn Sandberg
- Center for the Study of Sex Differences in Health, Disease and Aging Georgetown University, Washington, DC 20057
| | - Hong Ji
- Center for the Study of Sex Differences in Health, Disease and Aging Georgetown University, Washington, DC 20057
| |
Collapse
|
23
|
ROUSTIT MATTHIEU, CRACOWSKI JEANLUC. Non-invasive Assessment of Skin Microvascular Function in Humans: An Insight Into Methods. Microcirculation 2011; 19:47-64. [DOI: 10.1111/j.1549-8719.2011.00129.x] [Citation(s) in RCA: 194] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
24
|
Millet C, Roustit M, Blaise S, Cracowski J. Comparison between laser speckle contrast imaging and laser Doppler imaging to assess skin blood flow in humans. Microvasc Res 2011; 82:147-51. [DOI: 10.1016/j.mvr.2011.06.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Revised: 05/31/2011] [Accepted: 06/15/2011] [Indexed: 10/18/2022]
|
25
|
Miner JA, Martini ER, Smith MM, Brunt VE, Kaplan PF, Halliwill JR, Minson CT. Short-term oral progesterone administration antagonizes the effect of transdermal estradiol on endothelium-dependent vasodilation in young healthy women. Am J Physiol Heart Circ Physiol 2011; 301:H1716-22. [PMID: 21856917 DOI: 10.1152/ajpheart.00405.2011] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Very few studies have explored the cardiovascular effects of progesterone in premenopausal women. This study aimed to examine the short-term effects of oral progesterone alone, transdermal estrogen alone, and progesterone and estrogen combined on flow-mediated dilation (FMD) in healthy reproductive-aged women. We suppressed endogenous estrogens and progesterone in 17 premenopausal women for 10-12 days using a gonadotropin-releasing hormone antagonist. On day 4 (hormone suppression condition), subjects were tested (n = 17) and were then supplemented with either 200 mg micronized progesterone (n = 8) orally or 0.1 mg estradiol (n = 9) transdermally per day. On day 7 (progesterone-first or estradiol-first condition), subjects were tested and began supplementation with both hormones (n = 17) and were tested again on day 10 (combined hormone condition). FMD of the brachial artery was assessed using B-mode arterial ultrasound, combined with synchronized Doppler analysis. As a result, significant differences in FMD were observed between hormone suppression (7.85 ± 1.06%) and estrogen-first conditions (10.14 ± 1.40%; P < 0.05). The estradiol-induced increase was abolished when oral progesterone was also supplemented (6.27 ± 0.96%). In contrast, we observed a trend toward a decrease in FMD with unopposed progesterone administration, but no statistically significant differences were found between the progesterone-first (6.66 ± 1.23%), hormone suppression (7.80 ± 1.23%), and combined hormone conditions (7.40 ± 1.29%). In conclusion, these data suggest that short-term oral micronized progesterone administration antagonizes the beneficial effect of transdermal estradiol on FMD.
Collapse
Affiliation(s)
- Jennifer A Miner
- Department of Human Physiology, University of Oregon, Eugene, OR 97403, USA
| | | | | | | | | | | | | |
Collapse
|
26
|
THOMPSON ABBYK, PRZEMSKA AGNIESZKA, VASILOPOULOU DAFNI, NEWENS KATIEJ, WILLIAMS CHRISTINEM. Combined Oral Contraceptive Pills Containing Desogestrel or Drospirenone Enhance Large Vessel and Microvasculature Vasodilation in Healthy Premenopausal Women. Microcirculation 2011; 18:339-46. [DOI: 10.1111/j.1549-8719.2011.00094.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
27
|
Friedman J, Cremer M, Jelani QUA, Huang X, Jian J, Shah S, Katz SD. Oral contraceptive use, iron stores and vascular endothelial function in healthy women. Contraception 2011; 84:285-90. [PMID: 21843695 DOI: 10.1016/j.contraception.2011.01.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 01/12/2011] [Accepted: 01/12/2011] [Indexed: 12/22/2022]
Abstract
BACKGROUND Increased iron stores are associated with greater cardiovascular risk in postmenopausal women. Oral contraceptive pill (OCP) use decreases the volume of menstrual blood loss and increases iron stores, but the link between OCP use, iron stores and cardiovascular risk in premenopausal women has not been characterized. STUDY DESIGN We conducted a cross-sectional study of 23 healthy OCP users to determine the association between type and duration of OCP exposure, iron stores, and vascular endothelial function [flow-mediated dilation (FMD) in the brachial artery]. RESULTS Median duration of OCP use was 45 months. FMD in the brachial artery was significantly associated with progestin type used (estranes/gonanes vs. drospirenone) and duration of OCP use (both p<.05) but not iron stores. In multivariate analysis, progestin type was the only independent predictor of FMD. CONCLUSIONS Use of OCP containing drospirenone was independently associated with greater FMD in the brachial artery and, thus, a potentially more favorable cardiovascular risk profile, when compared with use of OCP containing estranes/gonanes.
Collapse
Affiliation(s)
- Julie Friedman
- Department of Medicine, New York University Langone Medical Center, New York, NY 10016, USA
| | | | | | | | | | | | | |
Collapse
|