Reckelhoff J F
Department of Physiology and Biophysics and the Center for Excellence in Cardiovascular-Renal Research, University of Mississippi Medical Center, Jackson 39216-4505, USA.
Hypertension. 2001 May;37(5):1199-208. doi: 10.1161/01.hyp.37.5.1199.
Men are at greater risk for cardiovascular and renal disease than are age-matched, premenopausal women. Recent studies using the technique of 24-hour ambulatory blood pressure monitoring have shown that blood pressure is higher in men than in women at similar ages. After menopause, however, blood pressure increases in women to levels even higher than in men. Hormone replacement therapy in most cases does not significantly reduce blood pressure in postmenopausal women, suggesting that the loss of estrogens may not be the only component involved in the higher blood pressure in women after menopause. In contrast, androgens may decrease only slightly, if at all, in postmenopausal women. In this review the possible mechanisms by which androgens may increase blood pressure are discussed. Findings in animal studies show that there is a blunting of the pressure-natriuresis relationship in male spontaneously hypertensive rats and in ovariectomized female spontaneously hypertensive rats treated chronically with testosterone. The key factor in controlling the pressure-natriuresis relationship is the renin-angiotensin system (RAS). The possibility that androgens increase blood pressure via the RAS is explored, and the possibility that the RAS also promotes oxidative stress leading to production of vasoconstrictor substances and reduction in nitric oxide availability is proposed.
与年龄匹配的绝经前女性相比，男性患心血管疾病和肾脏疾病的风险更高。最近使用24小时动态血压监测技术的研究表明，在相似年龄下，男性的血压高于女性。然而，绝经后，女性的血压会升高到甚至高于男性的水平。在大多数情况下，激素替代疗法并不能显著降低绝经后女性的血压，这表明雌激素的丧失可能不是绝经后女性血压升高的唯一因素。相比之下，绝经后女性的雄激素水平即使有所下降，幅度也很小。在这篇综述中，我们讨论了雄激素可能升高血压的潜在机制。动物研究结果表明，在雄性自发性高血压大鼠以及长期接受睾酮治疗的去卵巢雌性自发性高血压大鼠中，压力-利钠关系出现钝化。控制压力-利钠关系的关键因素是肾素-血管紧张素系统（RAS）。本文探讨了雄激素通过RAS升高血压的可能性，并提出RAS也可能促进氧化应激，导致血管收缩物质的产生以及一氧化氮可用性降低。
