Maric-Bilkan Christine, Manigrasso Michaele B
Department of Physiology and Biophysics, University of Mississippi Medical Center, 2500 N State St., Jackson, MS 39216-4505, USA.
Gend Med. 2012 Aug;9(4):287-91. doi: 10.1016/j.genm.2012.06.005. Epub 2012 Jul 12.
Numerous studies have shown that female human beings exhibit lower blood pressure levels over much of their life span compared with their age-matched counterparts. This sexual dimorphism is apparent in human beings as well as most, if not all, mammals. However, after the onset of menopause blood pressure levels in women increase and become similar to those in men, suggesting an important role of sex hormones in the regulation of blood pressure. The lower blood pressure levels in premenopausal women are associated with a lower risk of development and progression of cardiovascular disease and hypertension compared with age-matched men. This clear female advantage with respect to lower incidence of cardiovascular disease no longer exists after menopause, again highlighting the importance of sex hormones in the pathophysiology of cardiovascular disease in both men and women. In fact, both estrogens and androgens have been implicated in the development of cardiovascular disease and hypertension, with estrogens, in general, being protective and androgens being detrimental. Although the exact mechanisms by which sex hormones contribute to the regulation of cardiovascular function and blood pressure are still being investigated, there is increasing evidence that modulating the activity of locally active hormonal systems is one of the major mechanisms of sex hormone actions in target organs, including the vasculature and kidneys. Indeed, several studies have demonstrated the importance of the interaction between sex hormones and the renin-angiotensin system in regulating cardiovascular function and blood pressure. Furthermore, the differential effects of estrogens and androgens on the expression and activity of the components of the renin-angiotensin system could possibly explain the sex differences in blood pressure levels and the development and progression of cardiovascular disease and hypertension.
大量研究表明，在大部分生命跨度中，女性的血压水平相较于年龄匹配的男性更低。这种性别差异在人类以及大多数（即便不是全部）哺乳动物中都很明显。然而，绝经后女性的血压水平会升高并变得与男性相似，这表明性激素在血压调节中起着重要作用。与年龄匹配的男性相比，绝经前女性较低的血压水平与心血管疾病和高血压发生及进展风险较低相关。绝经后，这种女性在心血管疾病发病率较低方面的明显优势不再存在，这再次凸显了性激素在男性和女性心血管疾病病理生理学中的重要性。事实上，雌激素和雄激素都与心血管疾病和高血压的发生有关，一般来说，雌激素具有保护作用，而雄激素具有有害作用。尽管性激素调节心血管功能和血压的确切机制仍在研究中，但越来越多的证据表明，调节局部活性激素系统的活性是性激素在包括血管系统和肾脏在内的靶器官中发挥作用的主要机制之一。的确，多项研究已经证明了性激素与肾素 - 血管紧张素系统之间的相互作用在调节心血管功能和血压方面的重要性。此外，雌激素和雄激素对肾素 - 血管紧张素系统各成分表达和活性的不同影响可能解释了血压水平的性别差异以及心血管疾病和高血压的发生与进展。
