Conte Maria Rosa
Divisione di Cardiologia Ospedale degli Infermi Via Rivalta, 29 10098 Rivoli, TO, Italy.
Ital Heart J. 2003 Jun;4(6):367-70.
The cardiovascular system is regulated by many complex neurohumoral mechanisms which ensure the cardiac, cerebral and renal functions. The nervous control of the heart is mainly mediated by the vagal and sympathetic systems and by their interaction, known as the sympatho-vagal balance. An increased sympathetic tone is found in many abnormal situations, such as arterial hypertension, diabetes, chronic heart failure and myocardial infarction, and is associated with an increase in over-all mortality. The hormonal control of the cardiovascular system is mediated by various substances such as renin-angiotensin, catecholamines, insulin and estrogens, that are themselves correlated with the autonomic nervous system. In contrast to men, fertile women show a predominant vagal tone. Sex-related differences in the neurohumoral control of the cardiovascular system have been demonstrated during physical effort and in the hemodynamic adaptation to orthostatism. They have been postulated to explain the lower mortality in women compared to men among hypertensive or chronic heart failure patients. Prospective studies are needed to better define the gender differences in the pathophysiological mechanisms underlying cardiovascular diseases, in order to refine prevention and therapy.
心血管系统受多种复杂的神经体液机制调节，这些机制确保心脏、大脑和肾脏的功能。心脏的神经控制主要由迷走神经和交感神经系统及其相互作用介导，这种相互作用被称为交感-迷走平衡。在许多异常情况下，如动脉高血压、糖尿病、慢性心力衰竭和心肌梗死，会发现交感神经张力增加，且这与总体死亡率的增加有关。心血管系统的激素控制由各种物质介导，如肾素-血管紧张素、儿茶酚胺、胰岛素和雌激素，这些物质本身与自主神经系统相关。与男性不同，处于生育期的女性表现出主要的迷走神经张力。在体力活动期间以及在对直立位的血流动力学适应过程中，已证明心血管系统的神经体液控制存在性别差异。据推测，这些差异可以解释高血压或慢性心力衰竭患者中女性死亡率低于男性的原因。需要进行前瞻性研究，以更好地界定心血管疾病潜在病理生理机制中的性别差异，从而优化预防和治疗。
