Effect of orthostasis on endothelial function: a gender comparative study

PLoS One. 2013 Aug 2;8(8):e71655. doi: 10.1371/journal.pone.0071655. eCollection 2013.

Abstract

As the vascular endothelium has multiple functions, including regulation of vascular tone, it may play a role in the pathophysiology of orthostatic intolerance. We investigated the effect of orthostasis on endothelial function using EndoPAT®, a non-invasive and user-independent method, and across gender. As sex steroid hormones are known to affect endothelial function, this study examined the potential effect of these hormones on the endothelial response to orthostasis by including females at different phases of the menstrual cycle (follicular and luteal-where the hormone balance differs), and females taking an oral contraceptive. A total of 31 subjects took part in this study (11 males, 11 females having normal menstrual cycles and 9 females taking oral contraceptive). Each subject made two visits for testing; in the case of females having normal menstrual cycles the first session was conducted either 1-7 (follicular) or 14-21 days (luteal) after the start of menstruation, and the second session two weeks later, i.e., during the other phase, respectively. Endothelial function was assessed at baseline and following a 20-min orthostatic challenge (active standing). The EndoPAT® index increased from 1.71 ± 0.09 (mean ± SEM) at baseline to 2.07 ± 0.09 following orthostasis in females (p<0.001). In males, the index increased from 1.60 ± 0.08 to 1.94 ± 0.13 following orthostasis (p<0.001). There were no significant differences, however, in the endothelial response to orthostasis between females and males, menstrual cycle phases and the usage of oral contraceptive. Our results suggest an increased vasodilatatory endothelial response following orthostasis in both females and males. The effect of gender and sex hormones on the endothelial response to orthostasis appears limited. Further studies are needed to determine the potential role of this post orthostasis endothelial response in the pathophysiology of orthostatic intolerance.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Contraceptives, Oral
  • Dizziness / metabolism
  • Dizziness / pathology*
  • Dizziness / physiopathology*
  • Endothelium, Vascular / pathology*
  • Estrogens / metabolism
  • Female
  • Follicular Phase / metabolism
  • Gonadal Steroid Hormones / metabolism
  • Humans
  • Luteal Phase / metabolism
  • Male
  • Sex Characteristics*

Substances

  • Contraceptives, Oral
  • Estrogens
  • Gonadal Steroid Hormones

Grants and funding

Dr. Goswami received financial support from the Land Steiermark, Graz, Austria for the purchase of the EndoPAT probes and Dr. Gorur was supported by King’s College London, UK as the project formed part of his Space Physiology & Health MSc. The funders had no role in the study design, data colletion and analysis, decision to publish,or preparation of the mansucript.