Female Sex, a Major Risk Factor for Salt-Sensitive Hypertension.
Female Sex, a Major Risk Factor for Salt-Sensitive Hypertension.
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DOI：
10.1007/s11906-020-01113-6
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发表时间：
2020-10-21
影响因子：
5.6
通讯作者：
Belin de Chantemèle EJ
中科院分区：
文献类型：
--
作者：
Faulkner JL;Belin de Chantemèle EJ
在临床人群中，高盐饮食是导致原发性高血压的重要因素。然而，尽管临床研究表明，女性的盐敏感性高于男性，但对盐敏感机制的了解主要限于男性，目前正在阐明女性特有的机制。盐敏感型高血压的男性特有机制已经发表得很好，而且主要似乎涉及肾功能障碍。然而，新出现的证据表明，在盐敏感型高血压女性和雌性啮齿动物模型中，醛固酮的产生是性别特异性的，这可能受到肾上腺内肾素-血管紧张素系统激活和性激素受体的调节。此外，新的证据表明，年轻女性内源性表达较高水平的内皮糖皮质激素受体(MRS)，内皮MR是女性内皮功能障碍的关键介质，表明醛固酮-内皮MR激活途径是盐敏感型高血压的新介质。醛固酮水平的升高和内皮细胞MR的表达提供了一种性别特异性的2倍机制，这可能是女性盐敏感型高血压的病理基础。这一假设表明，MR拮抗剂可能是诊断为盐敏感型高血压的绝经前妇女的优先治疗方法。
High dietary salt is a significant contributor to essential hypertension in clinical populations. However, although clinical studies indicate a higher prevalence of salt sensitivity in women over men, knowledge of salt-sensitive mechanisms is largely restricted to males, and female-specific mechanisms are presently being elucidated. Male-specific mechanisms of salt-sensitive hypertension are well published and predominantly appear to involve dysfunctional renal physiology. However, emerging novel evidence indicates that aldosterone production is sex-specifically heightened in salt-sensitive hypertensive women and female rodent models, which may be regulated by intra-adrenal renin-angiotensin system activation and sex hormone receptors. In addition, new evidence that young females endogenously express higher levels of endothelial mineralocorticoid receptors (MRs) and that endothelial MR is a crucial mediator of endothelial dysfunction in females indicates that the aldosterone-endothelial MR activation pathway is a novel mediator of salt-sensitive hypertension. Heightened aldosterone levels and endothelial MR expression provide a 2-fold sex-specific mechanism that may underlie the pathology of salt-sensitive hypertension in women. This hypothesis indicates that MR antagonists may be a preferential treatment for premenopausal women diagnosed with salt-sensitive hypertension.
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影响因子：
8.3
作者：
Faulkner, Jessica L.;Harwood, Daisy;de Chantemele, Eric J. Belin
通讯作者：
de Chantemele, Eric J. Belin
影响因子：
1.9
作者：
CHOW, SY;SAKAI, RR;EPSTEIN, AN
通讯作者：
EPSTEIN, AN
影响因子：
2.9
作者：
KRECEK, J;STIBRAL, K;NOVAKOVA, V
通讯作者：
NOVAKOVA, V
影响因子：
37.8
作者：
Huby, Anne-Cecile;Antonova, Galina;de Chantemele, Eric J. Belin
通讯作者：
de Chantemele, Eric J. Belin
影响因子：
3.8
作者：
FLYNN, FW;SCHULKIN, J;HAVENS, M
通讯作者：
HAVENS, M