Blood Pressure In Young Women Research Articles

Hypertension and Hypertriglyceridemia in an Adolescent Girl Revealing Polycystic Ovary Syndrome: A Case Report

Polycystic ovary syndrome (PCOS) is a common clinical condition that manifests during adolescence with menstrual irregularities, acne and hirsutism. Patients with PCOS, especially with hyperandrogenic phenotype, are exposed to several cardiometabolic risk factors that increase their chance for developing hypertension. Little is known about the association between serum testosterone level and blood pressure in young women with PCOS but many of the symptoms associated with PCOS have been shown to be associated with increases in blood pressure, such as increases in body mass index and the presence of metabolic syndrome, with its accompanying insulin resistance and type 2 diabetes. We report the case of an 18-year-old female patient with no specific history who presented with edema of the lower limbs at the time of menstruation and in whom the clinical examination showed high blood pressure with signs of hyperandrogenism and hypertriglyceridemia in the biological work-up, leading to the search for a PCOS. After a well-adapted management the patient kept a well-balanced blood pressure with a lipidic balance which was normalized only by hygienic and dietetic rules.

Actigraphy-derived rest--activity rhythms are associated with nocturnal blood pressure in young women.

Misalignment between lifestyle behaviors and endogenous circadian rhythms is associated with elevated nocturnal blood pressure (BP) in experimental studies; however, less is known about free-living (i.e. nonlaboratory) circadian disruption and nocturnal BP. Additionally, sex-specific cardiovascular implications of circadian disruption are unclear. To examine the associations between rest--activity rhythms (RAR), a field-based estimate of circadian disruption, and nocturnal BP characteristics in young men and women. Fifty participants (20 ± 1 years; 20 men/30 women) underwent 24-h ambulatory BP monitoring following 14 days of wrist actigraphy. RAR variables of interdaily stability (day-to-day consistency in RAR), intradaily variability (within-day fragmentation of RAR), and relative amplitude (difference between peak vs. trough activity) were derived from actigraphy. Multivariable regression models of mean nocturnal SBP, DBP, and SBP dipping were generated to test main associations with RAR variables, and sex × RAR interactions. Daytime BP, race, BMI, physical activity, sleep duration, alcohol, caffeine, and sodium intake were considered as covariates. In the full sample, no main associations between RAR and nocturnal BP characteristics were found. Sex interacted with RAR such that in women, higher interdaily stability (β = -5.39, 95% CI = -10.04 to -0.73, P = 0.024) and relative amplitude (β = -4.78, 95% CI = -9.22 to -0.34, P = 0.036) were both associated with lower nocturnal SBP. Sex-stratified multivariable models of nocturnal BP also revealed associations between interdaily stability and relative amplitude with SBP dipping in women (all P ≤ 0.01). No associations were apparent in men. Consistent and high-amplitude RAR are favorably associated with nocturnal BP characteristics in young women.

Greater Influence of Aerobic Fitness on Autonomic Support of Blood Pressure in Young Women Than in Older Women.

Aging increases autonomic support of blood pressure; however, the impact of aerobic fitness on autonomic support of blood pressure has not been addressed in women. As such, we hypothesized that aerobic fitness would be related to the change in blood pressure during ganglionic blockade such that women with greater aerobic fitness would have a blunted fall in blood pressure during ganglionic blockade due to increased vagal tone. Thirteen young premenopausal and 13 older postmenopausal women completed a screening visit where aerobic fitness (maximal oxygen consumption, VO2max) was measured. On a separate study day, participants were instrumented for assessment of muscle sympathetic nerve activity, heart rate (electrocardiography), and beat by beat blood pressure (arterial catheter and pressure transducer) and underwent pharmacological blockade of the autonomic ganglia using trimethaphan camyslate. Heart rate, blood pressure, and muscle sympathetic nerve activity were analyzed before and during ganglionic blockade. In young women, there was a significant relationship between aerobic fitness and the change in blood pressure during ganglionic blockade (r=0.761, P=0.003). In older women, there was no relationship between aerobic fitness and the change in blood pressure during ganglionic blockade (r=-0.106, P=0.73). Measures of heart rate variability were related to fitness in young women, but not older women (root mean square of successive differences between normal heartbeats, r=0.713, P=0.006 versus r=-0.172, P=0.575). Our data suggest that in young women, autonomic support of blood pressure is attenuated in those that are highly fit; however, this relationship is not significant in older women.

Sex Differences in Sympathetic Control of Vascular Tone: Influences of Aging

Reproductive hormones have important non‐reproductive influences on cardiovascular structure and function. In women, these include important effects on the autonomic control of the circulation. Women under the age of 40 tend to have less tonic activity of sympathetic vasoconstrictor nerves in the periphery (usually measured as muscle sympathetic nerve activity), as well as smaller hearts and lower cardiac output compared to men of similar age and health status. Together, these result in a tendency for lower blood pressures in young women, including decreased risk for hypertension, and increased risk of hypotensive disorders such as orthostatic intolerance. Female reproductive hormones (particularly estrogen) appear to contribute to increased functional activity of vascular beta‐2 adrenergic receptors, which offset alpha‐adrenergic vasoconstriction and result in less vasoconstriction for a given amount of sympathetic neural activity (or local norepinephrine), also contributing to the lower blood pressure in young women compared to young men. At menopause, the influences of the hormones decreases, and sex differences are minimized or reversed: sympathetic nerve activity and blood pressure increase to levels similar to, or higher than, those seen in older men. The vasodilator influence of beta‐2 receptors decreases, and sympathetic nerve activity becomes more tightly linked to vasoconstriction and blood pressure. Sympathetic neural activity thus becomes a greater contributor to blood pressure with aging in both men and women, and is a factor in the increased risk of hypertension in older age in both sexes.Support or Funding InformationFunded by USAMRMC; author views not official US Army or DOD policyThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Sex‐specific Conditions Affecting Vascular Tone, Cerebral Blood Flow and Cognition

There are sex and sex‐hormone specific differences in autonomic nervous system control of blood pressure. The sympathetic nerve fibers of the autonomic nervous system innervate skeletal muscle blood vessels, initiating vasoconstriction, and thus regulate blood flow and vascular tone. This regulation of vascular tone is different between men and women, such that estrogen increases the activity of the b2‐adrenergic receptor activity (causing vasodilation) which offset sympathetically‐mediated vasoconstriction and results in lower blood pressure values in young women. Higher sympathetic nerve activity is associated with greater augmented aortic blood pressure in young men, but lower augmented aortic blood pressure in young women. Such differences in blood pressure regulation will likely have effects that extend beyond blood pressure, affecting blood flow, and ultimately tissue structure and function. For example, higher aortic blood pressure and greater arterial stiffness of the central arteries are associated with white matter hyperintensity fraction in normotensive postmenopausal women and older adults. In addition, there are conditions unique to women, menopause and pregnancy, that further affect blood pressure and blood flow regulation. Pregnancy constitutes a stress that challenges the regulation of blood pressure and blood flow in women. Hypertensive conditions of pregnancy, such as preeclampsia, carry life‐long risk for developing cardiovascular and cerebrovascular diseases. We evaluated the influence of pregnancy history in postmenopausal women on vascular function, cerebral blood flow, and cognition 35 years after pregnancy. Aortic blood pressure was associated with lower cognitive function scores in women with a history of preeclampsia. Additionally, women with a history of preeclampsia had lower cerebral blood flow responses to a vasodilatory stimulus and this was associated with greater intravascular cellular activation. Furthermore, women with a history of preeclampsia and with late‐life hypertension had atrophy in specific regions of the brain, suggesting that pregnancy history may later impact brain structure. Therefore, conditions that a woman may experience during pregnancy may be informative for future risk of disease. In summary, understanding sex‐specific physiological mechanisms, and how this may change over the lifespan is crucial for identification and treatment of individuals at accelerated risk of cardiovascular and cerebrovascular disease.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Associations between 25-hydroxyvitamin D levels, body composition and metabolic profiles in young women.

Cardiovascular disease (CVD) is a major cause of mortality and morbidity globally. Results from previous studies are inconsistent and it remains unclear whether low-serum 25 OHD levels are associated with an increased risk of CVD. These associations have been little studied in young women. The aim of this study was to assess the relationship between serum 25 OHD and obesity, body composition, metabolic profiles and blood pressure in young women. Women aged 16-25 years living in Victoria, Australia, were recruited through Facebook advertising in this cross-sectional study. Participants completed an online survey and attended a site visit in a fasted state, where parameters, including blood pressure, anthropometry, metabolic profiles, serum 25 OHD levels and body composition (using dual energy X-ray absorptiometry) were measured. A total of 557 participants were recruited into this study. Multiple linear regression analysis showed that after adjusting for visceral fat, season, smoking, physical activity, age, alcohol intake, oral contraceptive use, country of birth, taking multivitamins and taking vitamin D supplement, a 10 nmol/L increase in 25 OHD levels was associated with 0.65% greater HDL levels (p = 0.016) and 0.92% greater triglyceride levels (p = 0.003). It was also associated with 0.48% lower BMI (p < 0.001), 0.50% lower total fat percentage (p < 0.001), 0.09% lower visceral fat percentage (p < 0.001), 0.14% lower visceral fat to total fat ratio (p < 0.001) and 0.36% lower trunk fat to total fat ratio (p < 0.001), after adjustment for season, smoking, physical activity, age, alcohol intake, oral contraceptive use, country of birth, taking multivitamins and taking vitamin D supplements. Although these associations were statistically significant, they were very small in magnitude and of uncertain clinical significance. These findings may help to explain an association between 25 OHD levels and CVD risk factors through associations with HDL, BMI, total body and visceral fat mass. Possible underlying mechanisms warrant further investigation.

Вплив морфологічних факторів на рівні артеріального тиску в молодих жінок

Вплив морфологічних факторів на рівні артеріального тиску в молодих жінок

Discrimination of hie and hiesho using toe blood pressure in young women

ObjectiveIn Western medicine, hie (cold sensation) is thought as a subjective complaint. Consequently, despite women's complaints of health problems due to hie, such as distress and decreased quality of life, it is not diagnosed as a disease or given active treatment. However, hie sometimes requires emergency treatment or is a symptom of other disorders. Thus, diagnosing hie and eliminating distress due to hie are clinically significant. This research aimed to discriminate between hie and hiesho (cold disorder) and quantify hie by using objective assessments in addition to subjective assessments. MethodsA questionnaire was administered to 159 healthy young women without any underlying disease that could cause hie, followed by assessment of vascular function. These data were examined through exploratory factor analysis, exploratory cluster analysis, and multivariate logistic analysis. Two- and three-group comparisons were made using the Mann-Whitney test and Kruskal-Wallis test, respectively, followed by multiple comparisons using Scheffé's method. ResultsThe hie (including hiesho) and normal groups comprised 81 (51%) and 78 (49%) subjects, respectively. The questionnaire was a low reliability screening method for determining the severity of hie symptoms. As an index of discrimination of hie and hiesho, we determined the toe-brachial index (TBI) to be 0.81 and toe systolic blood pressure (SBP) to be 87.73 mmHg with a linear function (TBI=0.007 5×toe SBP+0.152, adjusted R2=0.829, F(1,79)=388.79, P<0.001). ConclusionToe SBP and TBI were suggested to be capable of discriminating and quantifying symptoms when used in combination with a questionnaire.

Changes in blood pressure and lipid levels in young women consuming a vitamin D-fortified skimmed milk: a randomised controlled trial.

Vitamin D exerts a variety of extra-skeletal functions. Aim: to know the effects of the consumption of a vitamin D-fortified skimmed milk on glucose, lipid profile, and blood pressure in young women. Methods: a randomised, placebo-controlled, double-blind parallel-group trial of 16 weeks duration was conducted in young women with low iron stores who consumed a skimmed milk fortified with iron and 200 IU/day (5 μg) of vitamin D (D-fortified group, n = 55), or a placebo without vitamin D (D-placebo group, n = 54). A reference group (n = 56) of iron-sufficient women was also recruited. Results: baseline serum 25-hydroxyvitamin D was inversely correlated with total-cholesterol (r = −0.176, p = 0.023) and low density lipoprotein-cholesterol (LDL-chol) (r = −0.176, p = 0.024). During the assay, LDL-cholesterol increased in the D-placebo group (p = 0.005) while it tended to decrease in the D-fortified group (p = 0.07). Neither group displayed changes in total-cholesterol, high density lipoprotein-cholesterol (HDL-chol), triglycerides or glucose levels. Systolic (p = 0.017) and diastolic (p = 0.010) blood pressure decreased during the assay in the D-fortified group without significant differences compared to the D-placebo. Conclusion: consumption of a dairy product fortified with vitamin D reduces systolic and diastolic blood pressure but does not change lipid levels in young women.

Persistent socioeconomic inequalities in cardiovascular risk factors in England over 1994-2008: A time-trend analysis of repeated cross-sectional data

BackgroundOur aims were to determine the pace of change in cardiovascular risk factors by age, gender and socioeconomic groups from 1994 to 2008, and quantify the magnitude, direction and change in absolute and relative inequalities.MethodsTime trend analysis was used to measure change in absolute and relative inequalities in risk factors by gender and age (16-54, ≥ 55 years), using repeated cross-sectional data from the Health Survey for England 1994-2008. Seven risk factors were examined: smoking, obesity, diabetes, high blood pressure, raised cholesterol, consumption of five or more daily portions of fruit and vegetables, and physical activity. Socioeconomic group was measured using the Index of Multiple Deprivation 2007.ResultsBetween 1994 and 2008, the prevalence of smoking, high blood pressure and raised cholesterol decreased in most deprivation quintiles. However, obesity and diabetes increased. Increasing absolute inequalities were found in obesity in older men and women (p = 0.044 and p = 0.027 respectively), diabetes in young men and older women (p = 0.036 and p = 0.019 respectively), and physical activity in older women (p = 0.025). Relative inequality increased in high blood pressure in young women (p = 0.005). The prevalence of raised cholesterol showed widening absolute and relative inverse gradients from 1998 onwards in older men (p = 0.004 and p ≤ 0.001 respectively) and women (p ≤ 0.001 and p ≤ 0.001).ConclusionsFavourable trends in smoking, blood pressure and cholesterol are consistent with falling coronary heart disease death rates. However, adverse trends in obesity and diabetes are likely to counteract some of these gains. Furthermore, little progress over the last 15 years has been made towards reducing inequalities. Implementation of known effective population based approaches in combination with interventions targeted at individuals/subgroups with poorer cardiovascular risk profiles are therefore recommended to reduce social inequalities.

Is greater resting sympathetic nerve activity better for hypertension? Perhaps for the arterial baroreflex

Is greater resting sympathetic nerve activity better for hypertension? Perhaps for the arterial baroreflex

Differential carotid baroreflex control of arterial blood pressure in young women and men at rest and during dynamic exercise

Arterial baroreceptors play a pivotal role in the rapid reflex adjustments that accompany acute cardiovascular stressors. Previous studies have demonstrated that the arterial blood pressure (BP) response of young women to cardiovascular stressors, such as exercise, was reduced compared to men. However, whether alterations in arterial baroreflex function contribute to sex differences in BP control remains unclear. To address this, 5s pulses of neck suction (NS, ‐60 Torr) and neck pressure (NP, +40 Torr) were applied to load and unload the carotid baroreflex (CBR), respectively at rest and during steady‐state cycling at 50% heart rate reserve in nine young women (22±1 yr) and nine men (22±1 yr). At rest, mean BP responses to NS were significantly greater in women (Δ‐16±1 women vs. Δ‐11±2 men mmHg; P=0.03), whereas responses to NP were similar between groups. Interestingly, exercise eliminated the group differences in mean BP responses to NS (Δ‐11±2 women vs. Δ‐11±2 men mmHg; P=0.98) however; responses to NP were significantly greater in women during exercise. These preliminary findings suggest that sex differences in CBR control of BP exist at rest and during exercise. In comparison to men, young women appear to be better able to defend against hypertensive challenges at rest, whereas during exercise women exhibit augmented CBR‐mediated BP responses to hypotension.Supported by R01HL093167.

Relationships among alcohol drinking, blood pressure and serum cholesterol in healthy young women

Background Habitual alcohol drinking affects both blood pressure and serum lipids. I investigated the relationships among alcohol drinking, blood pressure and atherogenic index defined by serum total and HDL cholesterol levels in young women. Methods The subjects were young (20–39 y) healthy female workers ( n = 7887) receiving annual health checkups. Blood pressure was compared in subjects divided into groups according to average daily alcohol consumption (non-drinkers; light drinkers, < 15 g/day ethanol; moderate-to-heavy drinkers, ≥ 15 g/day ethanol) and in subjects divided into tertile groups of atherogenic index calculated as (total cholesterol − HDL cholesterol)/HDL cholesterol. Results When overall subjects were analyzed, systolic and diastolic blood pressure in light and moderate-to-heavy drinkers was not significantly different from that in non-drinkers. Total cholesterol levels and atherogenic index were significantly lower and HDL cholesterol was significantly higher in the light and moderate-to-heavy drinker groups than in the non-drinker group. Atherogenic index and HDL cholesterol were also significantly lower and higher, respectively, in the moderate-to-heavy drinker group than in the light drinker group. In the lowest tertile group of atherogenic index, systolic and diastolic blood pressure after adjustment for age, body mass index, smoking history and atherogenic index was significantly higher in the moderate-to-heavy drinker groups than in the non-drinker group, while systolic and diastolic blood pressure was not different among the 3 alcohol consumption groups in the highest tertile group of atherogenic index. In non-, light and moderate-to-heavy drinker groups, systolic and diastolic blood pressure was significantly higher in the highest tertile group of atherogenic index than in the lowest and middle tertile groups. Conclusion Habitual alcohol drinking is related to blood pressure in young women with low atherogenic index but not in those with high atherogenic index, while blood pressure is associated with atherogenic index independently of alcohol drinking.

Polycystic Ovary Syndrome: Implications of Corticotropin in the Regulation of Blood Pressure, Aldosterone, and Androgen Secretion

To the Editor: In a recent issue of Hypertension , Chen et al1 have described a correlation between androgen levels and blood pressure in young women with polycystic ovary syndrome (PCOS), and this correlation was independent from age, insulin resistance, obesity, and dyslipidemia. We would like to discuss other factors involved in the interpretation of these data. High adrenal androgen levels in women with PCOS can also be related to an increase of corticotropin (ACTH). The major question is why …

Response to Polycystic Ovary Syndrome: Androgens, Autonomic Nervous System, and Hypertension

HomeHypertensionVol. 50, No. 1Response to Polycystic Ovary Syndrome: Androgens, Autonomic Nervous System, and Hypertension Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessLetterPDF/EPUBResponse to Polycystic Ovary Syndrome: Androgens, Autonomic Nervous System, and Hypertension Mei-Jou Chen Lian-Yu Lin Yu-Shih Yang Mei-Jou ChenMei-Jou Chen Departments of Obstetrics and Gynecology, National Taiwan University Hospital, and Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan Search for more papers by this author Lian-Yu LinLian-Yu Lin Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan Search for more papers by this author Yu-Shih YangYu-Shih Yang Departments of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan Search for more papers by this author Originally published30 Apr 2007https://doi.org/10.1161/HYPERTENSIONAHA.107.091801Hypertension. 2007;50:e8Other version(s) of this articleYou are viewing the most recent version of this article. Previous versions: April 30, 2007: Previous Version 1 We thank Dr Perciaccante1 and his colleague for their interest and insightful comments on our recent article2 regarding the association between the characteristic hyperandrogenemia and the elevated systolic and diastolic blood pressure in young women with polycystic ovary syndrome.Perciaccante et al propose that the cardiovascular autonomic nervous system might be affected directly by androgen levels or by hyperandrogenemia-induced insulin resistance and might, therefore, act as a possible link between androgen and blood pressure in women with polycystic ovary syndrome. We agree entirely that the mechanisms underlying hyperandrogenemia and elevated blood pressure are complex, and impaired autonomic nervous system might be a possible reason to explain this association.However, further investigation and controlled studies are still necessary to substantiate this hypothesis.Sources of FundingThis study was supported by grants NSC94-2314-B002-195 and NSC95-2314-B002-035 from the National Science Council of Taiwan.DisclosuresNone.1 Perciaccante A, Fiorentini A, Valente R, Tubani L. Polycystic ovary syndrome: androgens, autonomic nervous system, and hypertension. Hypertension. 2007: 50: e7.LinkGoogle Scholar2 Chen M-J, Yang W-S, Yang J-H, Chen C-L, Ho H-N, Yang Y-S. Relationship between androgen levels and blood pressure in young women with polycystic ovary syndrome. Hypertension. 2007: 49: 1442–1447.LinkGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetails July 2007Vol 50, Issue 1 Advertisement Article InformationMetrics https://doi.org/10.1161/HYPERTENSIONAHA.107.091801 Originally publishedApril 30, 2007 PDF download Advertisement SubjectsClinical Studies

Polycystic Ovary Syndrome: Androgens, Autonomic Nervous System, and Hypertension

To the Editor: We have read with interest the article by MJ Chen et al1 on the relationship between androgen levels and blood pressure in young women with polycystic ovary syndrome (PCOS). The authors have observed that characteristic hyperandrogenemia in young …

Relationship Between Androgen Levels and Blood Pressure in Young Women With Polycystic Ovary Syndrome

The role of testosterone on the development of hypertension is controversial, especially in women with polycystic ovary syndrome (PCOS) who have higher prevalence of obesity and insulin resistance than women without PCOS. Little is known about the association between serum testosterone level and blood pressure in young women with PCOS. In the 151 young Taiwanese women with PCOS enrolled in this cross-sectional study, we measured the body mass index, waist circumference, blood pressure, fasting glucose, fasting insulin, lipid profile, and hormone profiles. The free androgen index, total testosterone, and sex hormone-binding globulin, but not the level of dehydroepiandrosterone sulfate, significantly correlated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP). In multiple linear regression models adjusted for age, body mass index, and other anthropometric, metabolic, and hormonal variables, the level of serum free androgen index or total testosterone, but not the sex hormone-binding globulin, were independently related to SBP and DBP. The age- and body mass index-adjusted least-square mean of serum-free androgen index levels were significantly different between the highest quartile and other quartiles of the SBP and DBP levels. The high bioavailable testosterone levels (free androgen index: >or=19%) in women with PCOS increased the risk of elevated blood pressure (SBP >or=130 mm Hg and/or DBP >or=85 mm Hg) with an odds ratio of 3.817 (P=0.029; 95% CI: 1.14 to 12.74) after adjustment for age, anthropometric measures, and metabolic profiles. Our results suggest that the characteristic hyperandrogenemia in young women with PCOS was associated with an elevated SBP and DBP independent of age, insulin resistance, obesity, or dyslipidemia.

Relationship between morningness-eveningness, orthostatic disregulation syndrome, cornell medical index and 24-hour blood pressure in young women

Relationship between morningness-eveningness, orthostatic disregulation syndrome, cornell medical index and 24-hour blood pressure in young women