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1 Department of Anesthesia, Akita University School of Medicine, Akita-city, Akita, Japan
* To whom correspondence should be addressed. E-mail: mtanaka{at}med.akita-u.ac.jp.
This study was designed to determine baroreflex control of heart rate (HR) to hypotensive and hypertensive stimuli during the early follicular (EF), pre-ovulation (Pre-OV) and mid-luteal (ML) phases of the menstrual cycle, and to test the hypothesis that cardiovagal reflex responses to hypertensive stimuli would be altered depending on the plasma estradiol levels in healthy women. In addition, these results were compared with those obtained from male volunteers of similar age. Fifteen healthy women with regular menstrual cycles and 13 male volunteers participated in the study. Cardiovagal baroreflex sensitivity was defined as the slope of the linear portion relating R-R interval and systolic blood pressure triggered by bolus injections of nitroprusside and phenylephrine, from the overshoot phase of the Valsalva maneuver, and during spontaneous fluctuations. Three measurements were averaged in each test as a representative at each phase, and the order of phases was counterbalanced. No significant difference was detected in resting blood pressure and HR between menstrual cycle phases and genders. Baroreflex sensitivities by the phenylephrine pressor test and Valsalva maneuver during the Pre-OV phase were significantly greater than those during the EF and ML phases, but were similar to those of men. Depressor test sensitivities by nitroprusside and down-sequence spontaneous cardiac baroreflex sensitivity during the EF phase were significantly greater than those of the ML phase and of men. Significant correlations were observed between plasma estradiol concentrations vs. baroreflex sensitivities assessed by phenylephrine and the Valsalva maneuver. Our results indicate that baroreflex control of HR is altered during the regular menstrual cycle, and estradiol appears to exert cardiovagal modulation in healthy women.
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