Effect of aging on the cardiovascular regulatory systems in healthy women
Effect of aging on the cardiovascular regulatory systems in healthy women
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DOI：
10.1152/ajpregu.00352.2006
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发表时间：
2007-02-01
影响因子：
2.8
通讯作者：
Jacob, Giris
中科院分区：
文献类型：
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作者：
Lavi, Shahar;Nevo, Ori;Jacob, Giris
衰老独立于荷尔蒙状态，是健康女性心血管发病率的主要危险因素。因此，我们研究了健康老龄化对雌激素水平相近的绝经前和绝经后女性心血管内环境平衡机制的影响。12例健康绝经后妇女，经卵泡刺激素(FSH)和黄体激素(LH)水平证实，与14例月经正常的早期卵泡(YONG-EF)妇女进行比较，以尽可能避免雌激素的影响。青年EF组与绝经后组相比，收缩压分别为10 8+/-1.5vs.123+/-2.5(P&t；0.001)，仰卧位去甲肾上腺素为2 6 0+/-30vs2 16+/-45，直立位6 40+/-10 0vs.395+/-5 0pg/ml(P=0.0 5)。血浆肾素活性和醛固酮保持不变。迷走神经张力指数随年龄增长而显著降低：高频段620+/-140vs.270+/-70(P=0.04)，均方根连续差(RMSSD)23+/-5vs.270+/-70(P=0.04)，53+/-7vs.30+/-3(P=0.02)；青年EF的LF/HF比值为0.85+/-0.17，绝经后为1.5+/-0.22(P=0.03)。压力感受性反射的双臂，+BRS(29+/-5比13.5+/-2.5，P=0.01)和-BRS(26+/-4比15+/-1.5，P=0.02)随年龄增长而减少。与年轻的EF相比，绝经后患者的心血管α(1)-肾上腺素受体反应性显著增加，而β-受体反应性显著降低(P<；0.001)。绝经后组校正QT间期(QTC)相似，而校正JT间期(JTC)及JTC/QTC比值延长。我们的结论是，在年轻女性中，副交感神经控制是心血管系统的主要调节因素，而在绝经后女性中，交感神经张力占主导地位。从副交感神经控制到交感神经控制的转变可能是随着年龄的增长心血管发病率增加的原因。
Aging, independently from the hormonal status, is a major risk factor for cardiovascular morbidity in healthy women. Therefore, we studied the effect of healthy aging on the cardiovascular homeostatic mechanisms in premenopausal and postmenopausal women with similar estrogen levels. Twelve healthy postmenopausal women, confirmed by follicular-stimulating hormone (FSH) and luteal hormone (LH) levels, were compared with 14 normally menstruating women during the early follicular phase (young-EF), to avoid as much as possible the effects of estrogen. Systolic BP was 108 +/- 1.5 vs. 123 +/- 2.5 (P < 0.001), supine norepinephrine was 260 +/- 30 vs. 216 +/- 45 and upright 640 +/- 100 vs. 395 +/- 50 pg/ml (P = 0.05) in young-EF vs. postmenopausal, respectively. Plasma renin activity and aldosterone remained unchanged. Vagal cardiac tone indices decreased significantly with aging (young-EF vs. postmenopausal): high-frequency (HF) band, root mean square successive differences (rMSSD) and proportion of R-R intervals > 50 ms (PNN50%) were 620 +/- 140 vs. 270 +/- 70 (P = 0.04), 53 +/- 7 vs. 30 +/- 3 (P = 0.02), and 23 +/- 5 vs. 10 +/- 3 (P = 0.04), respectively. LF to HF ratio was 0.85 +/- 0.17 in young-EF and became 1.5 +/- 0.22 in postmenopausal (P = 0.03). Both arms of the baroreflex, + BRS (29 +/- 5 vs. 13.5 +/- 2.5, P = 0.01) and -BRS (26 +/- 4 vs. 15 +/- 1.5, P = 0.02) decreased with aging. Cardiovascular alpha(1)-adrenoreceptor responsiveness significantly increased and beta-decreased in postmenopausal compared with young EF (P < 0.001, both). The corrected QT intervals (QTc) were similar, whereas corrected JT intervals (JTc) and JTc to QTc ratio were prolonged in the postmenopausal group. We conclude that in young women, parasympathetic control is the main regulator of the cardiovascular system and in postmenopausal women, sympathetic tone dominates. The transition from parasympathetic to sympathetic control may contribute to the increased cardiovascular morbidity with aging.