Document Detail


Baroreflex function in females: changes with the reproductive cycle and pregnancy.
MedLine Citation:
PMID:  22483197     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This review briefly describes the changes in baroreflex function that occur during female reproductive life, specifically during the reproductive cycle and pregnancy. The sensitivity or gain of baroreflex control of heart rate and sympathetic activity fluctuates during the reproductive cycle, reaching a peak when gonadal hormone levels increase, during the follicular phase in women and proestrus in rats. The increase in baroreflex sensitivity (BRS) is likely mediated by estrogen because ovariectomy in rats eliminates the BRS increase, the cyclic profile of changes in BRS mirror the changes in estrogen, and estrogen acts in the brainstem to increase BRS. In contrast, pregnancy depresses both BRS and the maximal level of sympathetic activity and heart rate evoked by severe hypotension. The decrease in BRS may be mediated by a reduction in the actions of insulin in the arcuate nucleus to support the baroreflex. In addition, increased levels of the neurosteroid progesterone metabolite 3α-OH-DHP act downstream in the rostral ventrolateral medulla to suppress maximal baroreflex increases in sympathetic activity. Consequently, these changes in baroreflex function impair blood pressure regulation in the presence of hypotensive challenges such as orthostasis and hemorrhage, a common event during delivery. As a result, peripartum hemorrhage is a major cause of human maternal death.
Authors:
Virginia L Brooks; Priscila A Cassaglia; Ding Zhao; Robert K Goldman
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Gender medicine     Volume:  9     ISSN:  1878-7398     ISO Abbreviation:  Gend Med     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-09     Completed Date:  2013-02-27     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  101225178     Medline TA:  Gend Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  61-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved.
Affiliation:
Department of Physiology and Pharmacology, Oregon Health & Science University, Portland, Oregon 97239, USA. brooksv@ohsu.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Baroreflex / physiology*
Estrogens / physiology*
Estrous Cycle / physiology*
Female
Gonadal Steroid Hormones / physiology
Heart Rate / physiology
Humans
Insulin / physiology
Menstrual Cycle / physiology*
Models, Animal
Ovariectomy
Pregnancy / physiology*
Progesterone / physiology
Rats
Sympathetic Nervous System / physiology*
Grant Support
ID/Acronym/Agency:
HL088552/HL/NHLBI NIH HHS; R01 HL088552/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Estrogens; 0/Gonadal Steroid Hormones; 0/Insulin; 57-83-0/Progesterone
Comments/Corrections

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