O'Donnell Emma, Floras John S, Harvey Paula J
University Health Network and Mount Sinai Hospital, Division of Cardiology, Department of Medicine, University of Toronto, Canada; and
University Health Network and Mount Sinai Hospital, Division of Cardiology, Department of Medicine, University of Toronto, Canada; and.
Am J Physiol Regul Integr Comp Physiol. 2014 Sep 1;307(5):R498-500. doi: 10.1152/ajpregu.00182.2014. Epub 2014 Jun 18.
The renin-angiotensin-aldosterone system (RAAS) is integrally involved in multiple cardiovascular physiological processes including arterial blood pressure (BP) regulation. Over activity of the RAAS has been implicated in the pathogenesis of a number of cardiovascular disease entities, including hypertension. Several lines of evidence suggest estrogen favorably modulates the RAAS. Conversely, estrogen deficiency due to menopause may contribute to over activity of the RAAS. Of importance, estrogen deficiency in women is not exclusive to the postmenopausal period. Functional hypothalamic amenorrhea is a reversible cause of premenopausal hypoestrogenemia. In contrast to postmenopausal women (PMW), premenopausal women with exercise-associated functional hypothalamic amenorrhea demonstrate decreased, not increased, resting BP compared with their estrogen-replete eumenorrheic counterpart. In this review we briefly examine the effects of estrogen status on the RAAS and present the hypothesis that the RAAS is altered in physically active women with functional hypothalamic amenorrhea.
肾素-血管紧张素-醛固酮系统（RAAS）全面参与包括动脉血压（BP）调节在内的多个心血管生理过程。RAAS的过度激活与包括高血压在内的多种心血管疾病实体的发病机制有关。多项证据表明，雌激素可对RAAS产生有利调节作用。相反，绝经导致的雌激素缺乏可能会促使RAAS过度激活。重要的是，女性雌激素缺乏并非仅限于绝经后期。功能性下丘脑闭经是绝经前低雌激素血症的一个可逆原因。与绝经后女性（PMW）不同，与运动相关的功能性下丘脑闭经的绝经前女性与雌激素水平正常的月经正常女性相比，静息血压降低而非升高。在本综述中，我们简要探讨雌激素状态对RAAS的影响，并提出假说：在患有功能性下丘脑闭经的体育活动女性中，RAAS发生了改变。
