Department of Pharmacology, Tulane University , New Orleans, Louisiana.
Department of Biomedical Engineering, Tulane University , New Orleans, Louisiana.
Am J Physiol Heart Circ Physiol. 2018 Nov 1;315(5):H1073-H1087. doi: 10.1152/ajpheart.00132.2018. Epub 2018 Jul 20.
This review discusses sexual dimorphism in arterial stiffening, disease pathology interactions, and the influence of sex on mechanisms and pathways. Arterial stiffness predicts cardiovascular mortality independent of blood pressure. Patients with increased arterial stiffness have a 48% higher risk for developing cardiovascular disease. Like other cardiovascular pathologies, arterial stiffness is sexually dimorphic. Young women have lower stiffness than aged-matched men, but this sex difference reverses during normal aging. Estrogen therapy does not attenuate progressive stiffening in postmenopausal women, indicating that currently prescribed drugs do not confer protection. Although remodeling of large arteries is a protective adaptation to higher wall stress, arterial stiffening increases afterload to the left ventricle and transmits higher pulsatile pressure to smaller arteries and target organs. Moreover, an increase in aortic stiffness may precede or exacerbate hypertension, particularly during aging. Additional studies are needed to elucidate the mechanisms by which females are protected from arterial stiffness to provide insight into its mechanisms and, ultimately, therapeutic targets for treating this pathology.
这篇综述讨论了动脉僵硬的性别二态性、疾病病理相互作用，以及性别对机制和途径的影响。动脉僵硬独立于血压预测心血管死亡率。动脉僵硬增加的患者发生心血管疾病的风险增加 48%。与其他心血管病理一样，动脉僵硬具有性别二态性。年轻女性的僵硬程度低于年龄匹配的男性，但这种性别差异在正常衰老过程中会逆转。雌激素治疗并不能减轻绝经后妇女的动脉僵硬进展，这表明目前开的药物并不能提供保护。尽管大动脉重塑是对更高壁应力的一种保护适应性，但动脉僵硬会增加左心室的后负荷，并将更高的脉动压力传递到较小的动脉和靶器官。此外，主动脉僵硬的增加可能会导致或加重高血压，尤其是在衰老过程中。需要进一步的研究来阐明女性免受动脉僵硬影响的机制，以深入了解其机制，并最终为治疗这种病理提供治疗靶点。
