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Gender related differences in the cardiovascular responses to upright tilt in normal subjects

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Abstract

The heart rate and blood pressure responses to head-up tilt of 80 degrees was studied in 20 normal men and 21 normal women aged 20–50 years (mean age 31.1 ± 7.1 years). The heart rate increase in females during tilt was 73% that of males, whereas the increase in diastolic pressure during tilt was 29% of males. Expressed in relation to values obtained supine, heart rate increases on average 30.3% in men as compared to 21.5% in women whereas diastolic pressure increases by 15.2% in men as compared to an increase of only 4.3% in women. The data indicates that the cardiovascular response of normal females to upright tilt differs significantly from that of normal males. This attenuated responsiveness to ortho-stasis in women relative to men may predispose women to postural insufficiency and may account for the predominance of symptomatic women with clinically mild dysautonomia.

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References

  1. Wooley CF. Where are the diseases of yesteryear? Da Costa's syndrome, soldier's heart, the effort syndrome, neurocirculatory asthenia and the mitral valve prolapse syndrome.Circulation 1976;53: 749–751.

    PubMed  Google Scholar 

  2. Streeten DHP, Kerr LP, Kerr CB, Prior JC, Dalakos TG. Hyperbradykininism: a new orthostatic syndrome.Lancet 1972;ii: 1048–1053.

    Google Scholar 

  3. Polinsky RJ, Kopin IJ, Ebert MH, Weise V. Pharmacologic distinction of different orthostatic hypotension syndromes.Neurology 1981;31: 1–7.

    Google Scholar 

  4. Hoeldtke RD, Dworkin GE, Gaspar SR, Israel BC. Sympathotonic orthostatic hypotension: a report of four cases.Neurology 1989;39: 34–40.

    PubMed  Google Scholar 

  5. Rosen SG, Cryer PE. Postural tachycardia syndrome: reversal of sympathetic hyperresponsiveness and clinical improvement during sodium loading.Am J Med 1982;72: 847–850.

    PubMed  Google Scholar 

  6. Schondorf R, Low PA. Idiopathic postural tachycardia syndrome.Ann Neurol 1990;28: 271.

    Google Scholar 

  7. Fouad FM, Tadena-Thome L, Bravo EL, Tarazi RC. Idiopathic hypovolemia.Ann Int Med 1986;104: 298–303.

    PubMed  Google Scholar 

  8. Taylor AA, Davies AO, Mares A, Raschko J, Pool JL, Nelson EB, Mitchell JR. Spectrum of dysautonomia in mitral valvular prolapse.Am J Med 1989;86: 267–274.

    PubMed  Google Scholar 

  9. Chesler E, Weir EK, Braatz GA, Francis GS. Normal catecholamine and hemodynamic responses to orthostatic tilt in subject with mitral valve prolapse: Correlation with psychologic testing.Am J Med 1985;78: 754–760.

    PubMed  Google Scholar 

  10. Coghlan HC, Phares P, Cowley M, Copley D, James TN. Dysautonomia in mitral valve prolapse.Am J Med 1979;67: 236–244.

    PubMed  Google Scholar 

  11. Pasternac A, Tubau JF, Puddu PE, Krol RB, De Champlain J. Increased plasma catecholamine levels in patients with symptomatic mitral valve prolapse.Am J Med 1982;73: 783–790.

    PubMed  Google Scholar 

  12. Boudolas H, Reynolds JC, Mazzaferri E, Wooley CF. Mitral valve prolapse syndrome: the effect of adrenergic stimulation.J Am Coll Cardiol 1983;2: 638–644.

    PubMed  Google Scholar 

  13. Weissman NJ, Katherine-Shear M, Kramer-Fox F, Devereux RB. Contrasting patterns of autonomic dysfunction in patients with panic attacks and mitral valve prolapse.Am J Med 1987;82: 880–888.

    PubMed  Google Scholar 

  14. Shvartz E, Meyerstein N. Tilt tolerance of young men and young women.Aerospace Med 1970;41: 253–255.

    Google Scholar 

  15. Moore KI, Newton K. Orthostatic heart rates and blood pressure in healthy young men and women.Heart and Lung 1986;15: 611–617.

    PubMed  Google Scholar 

  16. Montgomery LD, Kirk PJ, Payne PA, Gerber RL, Newton SD, Williams BA. Cardiovascular responses of men and women to lower body negative pressure.Aviat Space Environ Med 1977;48: 138–145.

    PubMed  Google Scholar 

  17. Schondorf R, Low PA. Comparison of the cardiovascular response to tilt of normal male and female subjects.Neurology 1991;41 (suppl 1): 354.

    Google Scholar 

  18. Akselrod S, Gordon D, Madwed JB, Snidman NC, Shannon DC, Cohen RJ. Hemodynamic regulation: investigation by spectral analysis.Am J Physiol 1985;249: H867-H875.

    PubMed  Google Scholar 

  19. Pagani M, Lombardi F, Guzetti S, Rimoldi O, Furlan R, Pizzinelli P, Sandrone G, Malfatto G, Dell'Orto S, Piccaluga E, Turiel M, Baselli G, Serutti S, Malliani A. Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog.Circ Res 1986;59: 178–193.

    PubMed  Google Scholar 

  20. Johansson SR, Hjalmarson A. Age and sex differences in cardiovascular reactivity to adrenergic agonists, mental stress and isometric exercise in normal subjects.Scand J Lab Invest 1988;48: 183–191.

    Google Scholar 

  21. Michelsen S, Otterstad JE. Blood pressure during maximal exercise in apparently healthy men and women.J Intern Med 1990;227: 157–163.

    PubMed  Google Scholar 

  22. Miyamoto Y, Tamura T, Hiura T, Nakamura T, Higuchi J, Mikami T. The dynamic response of the cardiopulmonary parameters to passive head-up tilt.Jap J Physiol 1982;32: 245–258.

    PubMed  Google Scholar 

  23. Greenberg G, Imeson JD, Thompson SG, Meade TW. Blood pressure and the menstrual cycle.Br J Obstet Gynaecol 1985;92: 1010–1014.

    PubMed  Google Scholar 

  24. Scott AR, Macdonald IA, Bowman CA, Jeffcoate WJ. Effect of phase of menstrual cycle on insulin sensitivity, peripheral blood flow and cardiovascular responses to hyperinsulinaemia in young women with type 1 diabetes.Diabetic Med 1990;7: 57–62.

    PubMed  Google Scholar 

  25. Kelleher C, Joyce C, Kelly G, Ferriss JB. Blood pressure alters during the normal menstrual cycle.Br J Obstet Gynaecol 1986;93: 523–526.

    PubMed  Google Scholar 

  26. Hassan AAK, Carter G, Tooke JE. Postural vasoconstriction in women during the normal menstrual cycle.Clin Sci 1990;78: 39–47.

    PubMed  Google Scholar 

  27. Altura BM. Sex as a factor influencing the responsiveness of arterioles to catecholamines.Eur J Pharmacol 1972;20: 261–265.

    PubMed  Google Scholar 

  28. Freedman RR, Sabharwal SC, Desai N. Sex differences in peripheral vascular adrenergic receptors.Circ Res 1987;61: 581–585.

    PubMed  Google Scholar 

  29. Cooke JP, Crager MA, Osmundson PJ, Shepherd JT. Sex differences in control of cutaneous blood flow.Circulation 1990;82: 1607–1615.

    PubMed  Google Scholar 

  30. Bunag RD, Walaszek EJ, Mueting N. Sex differences in reflex tachycardia induced by hypotensive drugs in unanesthetized rats.Am J Physiol 1975;229: 652–656.

    PubMed  Google Scholar 

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Schondorf, R., Low, P.A. Gender related differences in the cardiovascular responses to upright tilt in normal subjects. Clinical Autonomic Research 2, 183–187 (1992). https://doi.org/10.1007/BF01818960

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  • DOI: https://doi.org/10.1007/BF01818960

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