title: Sex differences in noninvasive vascular function in the community.
abstract: OBJECTIVE
  The relation of noninvasive vascular function to sex, sex hormones, and reproductive history in the general population is little understood.
  
  
  METHODS
  We simultaneously assessed flow-mediated dilation (FMD) and peripheral arterial tonometry in 454 women (mean age 40.4±16.1 years, age range 19-78 years) and 100 men (mean age 44.7±15.3 years) in a community-based cohort. Plasma estradiol, progesterone, luteinizing hormone, and follicle stimulating hormones were measured, and menstrual cycle and reproductive history were recorded.
  
  
  RESULTS
  Vascular function was blunted in men as compared to women irrespective of menopausal status and adjustment for classical cardiovascular risk factors and hormones. Vascular reactivity changed during the menstrual cycle and correlated with estradiol concentrations for FMD, r=0.13 and inversely with progesterone for pulse amplitude, r=-0.14, and brachial artery diameter, r=-0.10. Multivariable-adjusted regressions showed a relation of estradiol with FMD, β 0.658, 95% confidence interval (CI) 0.084/1.232, P=0.025 in women. Age at menarche (β 0.070, 95% CI 0.039/0.101, P<0.0001) and breastfeeding duration (β -0.006, 95% CI -0.011/-0.001, P=0.036) were related to brachial artery diameter, age at menarche also to FMD (β -0.455, 95% CI -0.886/-0.023, P=0.039).
  
  
  CONCLUSIONS
  Sex differences in noninvasive conduit and peripheral arterial function with better vascular reactivity in women were not fully explained by female sex hormones and menopausal status. Age at menarche and duration of breastfeeding were also related to vascular function and need further investigation.
authors.affiliation: Department of General and Interventional Cardiology, University Heart Center, Hamburg Eppendorf, Hamburg, Germany. schnabelr@gmx.de
authors.forename: Renate B
authors.initials: RB
authors.lastname: Schnabel
authors.forename: Moritz P
authors.initials: MP
authors.lastname: Biener
authors.forename: Sandra
authors.initials: S
authors.lastname: Wilde
authors.forename: Christoph R
authors.initials: CR
authors.lastname: Sinning
authors.forename: Francisco M
authors.initials: FM
authors.lastname: Ojeda
authors.forename: Tanja
authors.initials: T
authors.lastname: Zeller
authors.forename: Edith
authors.initials: E
authors.lastname: Lubos
authors.forename: Karl J
authors.initials: KJ
authors.lastname: Lackner
authors.forename: Ascan
authors.initials: A
authors.lastname: Warnholtz
authors.forename: Tommaso
authors.initials: T
authors.lastname: Gori
authors.forename: Christine
authors.initials: C
authors.lastname: Espinola-Klein
authors.forename: Stefan
authors.initials: S
authors.lastname: Blankenberg
authors.forename: Thomas
authors.initials: T
authors.lastname: Munzel
authors.forename: Philipp S
authors.initials: PS
authors.lastname: Wild
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001808:Blood Vessels / Q000502:physiology*; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008593:Menopause; D008875:Middle Aged; D011374:Progesterone / Q000097:blood; D012737:Sex Factors; D055815:Young Adult
chemical_list: D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone