性别特异性内皮素在高血压中的作用。
Sex-Specific Contributions of Endothelin to Hypertension.
机构信息
Section of Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35233, USA.
Department of Pharmacology and Toxicology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt.
出版信息
Curr Hypertens Rep. 2018 Jun 8;20(7):58. doi: 10.1007/s11906-018-0856-0.
PURPOSE OF REVIEW
Men and women differ in the prevalence, pathophysiology and control rate of hypertension in an age-dependent manner. The renal endothelin system plays a central role in sex differences in blood pressure regulation by control of sodium excretion and vascular function. Improving our understanding of the sex differences in the endothelin system, especially in regard to blood pressure regulation and sodium homeostasis, will fill a significant gap in our knowledge and may identify sex-specific therapeutic targets for management of hypertension.
RECENT FINDINGS
The current review will highlight evidence for the potential role for endothelin system in the pathophysiology of hypertension within three female populations: (i) postmenopausal women, (ii) women suffering from preeclampsia, or (iii) pulmonary arterial hypertension. Clinical trials that specifically address cardiovascular and renal diseases in females under different hormonal status are limited. Studies of the modulatory role of gonadal hormones and sex-specific mechanisms on critically important systems involved, such as endothelin, are needed to establish new clinical practice guidelines based on systematic evidence.
目的综述
男性和女性的高血压患病率、病理生理学和控制率随年龄的变化而不同。肾内皮素系统通过控制钠排泄和血管功能在血压调节的性别差异中起着核心作用。提高我们对内皮素系统性别差异的理解，特别是在血压调节和钠平衡方面，将填补我们知识中的一个重大空白，并可能确定针对高血压管理的特定性别治疗靶点。
最近的发现
本综述将重点介绍内皮素系统在以下三种女性人群的高血压病理生理学中的潜在作用的证据：（i）绝经后妇女，（ii）患有先兆子痫的妇女，或（iii）肺动脉高压。专门针对不同激素状态下女性心血管和肾脏疾病的临床试验是有限的。需要研究性腺激素的调节作用和关键系统（如内皮素）的性别特异性机制，以基于系统证据制定新的临床实践指南。
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