Baroreflex function in females: Changes with the reproductive cycle and pregnancy

Virginia L. Brooks, Priscila A. Cassaglia, Ding Zhao, Robert K. Goldman

Research output: Contribution to journalReview article

21 Scopus citations

Abstract

This review briefly describes the changes in baroreflex function that occur during female reproductive life, specifically during the reproductive cycle and pregnancy. The sensitivity or gain of baroreflex control of heart rate and sympathetic activity fluctuates during the reproductive cycle, reaching a peak when gonadal hormone levels increase, during the follicular phase in women and proestrus in rats. The increase in baroreflex sensitivity (BRS) is likely mediated by estrogen because ovariectomy in rats eliminates the BRS increase, the cyclic profile of changes in BRS mirror the changes in estrogen, and estrogen acts in the brainstem to increase BRS. In contrast, pregnancy depresses both BRS and the maximal level of sympathetic activity and heart rate evoked by severe hypotension. The decrease in BRS may be mediated by a reduction in the actions of insulin in the arcuate nucleus to support the baroreflex. In addition, increased levels of the neurosteroid progesterone metabolite 3α-OH-DHP act downstream in the rostral ventrolateral medulla to suppress maximal baroreflex increases in sympathetic activity. Consequently, these changes in baroreflex function impair blood pressure regulation in the presence of hypotensive challenges such as orthostasis and hemorrhage, a common event during delivery. As a result, peripartum hemorrhage is a major cause of human maternal death.

Original languageEnglish (US)
Pages (from-to)61-67
Number of pages7
JournalGender Medicine
Volume9
Issue number2
DOIs
StatePublished - Apr 2012

Keywords

  • 3α-OH-DHP-baroreflex sensitivity
  • hemorrhage
  • insulin
  • sympathetic nerve activity

ASJC Scopus subject areas

  • Gender Studies

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