© 2002 by European Society of Cardiology
Copyright © 2002, European Society of Cardiology
Gender, sex hormones and autonomic nervous control of the cardiovascular system
Baker Medical Research Institute and Alfred Hospital, Commercial Road, Prahran, Victoria 3181, Australia
* Corresponding author. Tel.: +61-3-9276-2071; fax: +61-3-9276-2495 a.dart@alfred.org.au
Received 15 June 2001; accepted 11 October 2001
KEYWORDS Adrenergic (ant)agonists; Autonomic nervous system; Gender; Hormones
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1. Introduction |
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The autonomic nervous system is of importance in the natural history and treatment of a number of pathophysiological states involving the cardiovascular system. These include hypertension and diseases of the vasculature as well as myocardial ischaemia and cardiac arrhythmias. Gender differences in the incidence and clinical course of a range of cardiovascular states are also well recognised. Both short and long term prognosis after myocardial infarction are worse for women than men [1–4], whereas women with non-ischaemic cardiomyopathy have improved survival [5,6]. In addition to the well known difference in age of presentation of coronary heart disease, women are more likely to suffer from Raynaud's phenomenon, and to experience presyncopal or syncopal episodes. An appreciation of gender differences in the structure and function of the autonomic nervous system is therefore important to a full understanding of a number of common and important clinical presentations [7].
Gender differences
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2. Methods of assessment of autonomic nervous activity |
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3. Physiology |
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3.1. Basal state
3.2. Sympathoadrenergically mediated vasoconstriction
3.3. Responses to stressors
3.3.1. Posture, valsalva manoeuvre and deep breathing
3.3.2. Exercise
3.3.3. Hypoglycemia
3.3.4. Hypoxia and hyperoxia
3.3.5. Cold temperature and mental stress
3.3.6. Neuronal reflexes controlling cardiovascular function
3.4. Summary
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4. Aging and pathophysiology |
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4.1. Aging
4.2. Obesity
4.3. Myocardial ischaemia and arrhythmias
4.4. Summary
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5. Mechanisms for the sex differences in the autonomic nervous system |
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5.1. Central effects of gonadal hormones
5.2. Peripheral effects of gonadal hormones
5.3. Summary
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6. Conclusions |
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