Document Detail


Menstrual cycle affects renal-adrenal and hemodynamic responses during prolonged standing in the postural orthostatic tachycardia syndrome.
MedLine Citation:
PMID:  20479333     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Approximately 500,000 American premenopausal women have the postural orthostatic tachycardia syndrome (POTS). We tested the hypothesis that in POTS women during orthostasis, activation of the renin-angiotensin-aldosterone system is greater, leading to better compensated hemodynamics in the midluteal phase (MLP) than in the early follicular phase of the menstrual cycle. Ten POTS women and 11 healthy women (controls) consumed a constant diet 3 days before testing. Hemodynamics and renal-adrenal hormones were measured while supine and during 2-hour standing. We found that blood pressure was similar, heart rate and total peripheral resistance were greater, and cardiac output and stroke volume were lower in POTS subjects than in controls during 2-hour standing. In controls, hemodynamic parameters were indistinguishable between menstrual phases. In POTS subjects, cardiac output and stroke volume were lower and total peripheral resistance was greater in the early follicular phase than MLP after 30 minutes of standing; however, blood pressure and heart rate were similar between phases. Plasma renin activity (9+/-6 [SD] versus 13+/-9 ng/mL per hour; P=0.04) and aldosterone (43+/-22 versus 55+/-25 ng/dL; P=0.02) were lower in the early follicular phase than MLP in POTS subjects after 2 hours of standing. Catecholamine responses were similar between phases. The percentage rate of subjects having presyncope was greater in the early follicular phase than MLP for both groups (chi(2) P<0.01). These results suggest that the menstrual cycle modulates the renin-angiotensin-aldosterone system and affects hemodynamics during orthostasis in POTS. The high estrogen and progesterone in the MLP are associated with greater increases in renal-adrenal hormones and presumably more volume retention, which improve late-standing tolerance in these patients.
Authors:
Qi Fu; Tiffany B VanGundy; Shigeki Shibata; Richard J Auchus; Gordon H Williams; Benjamin D Levine
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2010-05-17
Journal Detail:
Title:  Hypertension     Volume:  56     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-17     Completed Date:  2010-07-15     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  82-90     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aldosterone / blood*
Catecholamines / blood*
Chromatography, High Pressure Liquid
Estradiol / blood
Female
Hemodynamics / physiology*
Humans
Incidence
Menstrual Cycle / physiology*
Postural Orthostatic Tachycardia Syndrome / blood,  epidemiology,  physiopathology*
Progesterone / blood
Radioimmunoassay
Renin / blood*
Retrospective Studies
Texas / epidemiology
Grant Support
ID/Acronym/Agency:
CA00701/CA/NCI NIH HHS; HL075283/HL/NHLBI NIH HHS; K23 HL075283/HL/NHLBI NIH HHS; K23 HL075283-01/HL/NHLBI NIH HHS; K23 HL075283-02/HL/NHLBI NIH HHS; K23 HL075283-03/HL/NHLBI NIH HHS; K23 HL075283-04/HL/NHLBI NIH HHS; K23 HL075283-05/HL/NHLBI NIH HHS; K23HL075283/HL/NHLBI NIH HHS; RR00633/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Catecholamines; 4964P6T9RB/Aldosterone; 4G7DS2Q64Y/Progesterone; 4TI98Z838E/Estradiol; EC 3.4.23.15/Renin
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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